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01.11.2022 | Breast Radiology

Diagnostic performance of 2D-shear wave elastography in the diagnosis of breast cancer: a clinical appraisal of cutoff values

verfasst von: Tommaso Vincenzo Bartolotta, Alessia Angela Maria Orlando, Mariangela Dimarco, Calogero Zarcaro, Fabiola Ferraro, Alessandra Cirino, Domenica Matranga, Salvatore Vieni, Daniela Cabibi

Erschienen in: La radiologia medica | Ausgabe 11/2022

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Abstract

Purpose

To assess the role of 2D-shear wave elastography (2D-SWE) in differentiating benign from malignant focal breast lesions (FBLs), providing new vendor-specific cutoff values.

Methods

158 FBLs (size: 3.5–50 mm) detected in 151 women (age: 21–87 years) were prospectively evaluated by means 2D-SWE. For each lesion, an expert radiologist assessed US BI-RADS category and calculated the following four 2D-SWE parameters: (1) elasticity maximum (E_max); (2) mean elasticity (E_mean); (3) minimum elasticity (E_min); (4) elasticity ratio (E_ratio). US-guided core-biopsy was considered as standard of reference for all the FBLs classified as BI-RADS 4 or 5. For each 2D-SWE parameter, the optimal cutoff value for a diagnostic test was calculated using the Youden method. Diagnostic performance of the US BI-RADS and 2D-SWE parameters was calculated accordingly.

Results

83/158 (52.5%) FBLs were benign and 75/158 (47.5%) were malignant. Statistically significant higher stiffness values were observed in malignant FBLs for all 2D-SWE parameters than in benign ones (p < 0.001). 2D-SWE cutoff values were 82.6 kPa, 66.0 kPa and 53.6 kPa, respectively, for E_max, E_mean, E_min and 330.8% for E_ratio. The 2D-SWE parameter showing the best diagnostic accuracy was E_max (85.44%). Considering US BI-RADS 3 (n = 60) and 4a (n = 32) FBLs, E_max and E_mean showed the best diagnostic accuracy (85.87% for both), without a statistically significant decrease in sensitivity (p = 0.7003 and p = 1, respectively).

Conclusion

Our study provides new vendor-specific cutoff values for 2D-SWE, suggesting its possible clinical use in the adjunctive assessment of category US-BI-RADS 3 and 4a breast masses.

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Titel: Diagnostic performance of 2D-shear wave elastography in the diagnosis of breast cancer: a clinical appraisal of cutoff values
verfasst von: Tommaso Vincenzo Bartolotta
Alessia Angela Maria Orlando
Mariangela Dimarco
Calogero Zarcaro
Fabiola Ferraro
Alessandra Cirino
Domenica Matranga
Salvatore Vieni
Daniela Cabibi
Publikationsdatum: 01.11.2022
Verlag: Springer Milan
Erschienen in: La radiologia medica / Ausgabe 11/2022
Print ISSN: 0033-8362
Elektronische ISSN: 1826-6983
DOI: https://doi.org/10.1007/s11547-022-01546-w

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Diagnostic performance of 2D-shear wave elastography in the diagnosis of breast cancer: a clinical appraisal of cutoff values