Three-dimensional shear wave elastography for differentiation of breast lesions: An initial study with quantitative analysis using three orthogonal planes

Article type: Research Article

Authors: Wang, Qiao^a | Li, Xiao-Long^a | He, Ya-Ping^a | Alizad, Azra^b | Chen, Shigao^b | Zhao, Chong-Ke^{a; *} | Guo, Le-Hang^a | Bo, Xiao-Wan^a | Ren, Wei-Wei^a | Zhou, Bang-Guo^a | Xu, Hui-Xiong^{a; *}

Affiliations: [a] Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China | [b] Department of Radiology, Mayo Clinic, Rochester, MN, USA

Correspondence: [*] Corresponding authors: Hui-Xiong Xu and Chong-Ke Zhao, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, No 301, Yanchangzhong Road, Shanghai 200072, China. Tel.: +86 21 66307539, Fax: +86 21 66301031(O), E-mails: [email protected] and [email protected].

Abstract: OBJECTIVES:To prospectively evaluate the diagnostic performance of three-dimensional (3D) shear wave elastography (SWE) for breast lesions with quantitative stiffness information from transverse, sagittal and coronal planes. METHODS:Conventional ultrasound (US), two-dimensional (2D)-SWE and 3D-SWE were performed for 122 consecutive patients with 122 breast lesions before biopsy or surgical excision. Maximum elasticity values of Young’s modulus (Emax) were recorded on 2D-SWE and three planes of 3D-SWE. Area under the receiver operating characteristic curve (AUC), sensitivity and specificity of US, 2D-SWE and 3D-SWE were evaluated. Two combined sets (i.e., BI-RADS and 2D-SWE; BI-RADS and 3D-SWE) were compared in AUC. Observer consistency was also evaluated. RESULTS:On 3D-SWE, the AUC and sensitivity of sagittal plane were significantly higher than those of transverse and coronal planes (both P < 0.05). Compared with BI-RADS alone, both combined sets had significantly (P < 0.05) higher AUCs and specificities, whereas, the two combined sets showed no significant difference in AUC (P > 0.05). However, the combined set of BI-RADS and sagittal plane of 3D-SWE had significantly higher sensitivity than the combined set of BI-RADS and 2D-SWE. CONCLUSIONS:The sagittal plane shows the best diagnostic performance among 3D-SWE. The combination of BI-RADS and 3D-SWE is a useful tool for predicting breast malignant lesions in comparison with BI-RADS alone.

Keywords: Breast, ultrasound, three-dimensional, shear wave elastography, quantitative analysis

DOI: 10.3233/CH-180388

Journal: Clinical Hemorheology and Microcirculation, vol. 71, no. 3, pp. 311-324, 2019