Value of Shear Wave Elastography in Discriminating Category IV Breast Lesions According to Breast Imaging-Reporting and Data System
Al- Anbar Medical Journal,
2022, Volume 18, Issue 1, Pages 21-26
10.33091/amj.2021.174526
Abstract
Background: Breast cancer is the second cause of cancer death in women. Shear wave elastography (SWE) is an ultrasound (US) procedure that can improves the sensitivity and the specificityin the diagnosis of breast lesions.
Objectives: To evaluate the value of SWE to discriminate benign from malignant Breast
Imaging-Reporting and Data System (BI-RADS) IV breast lesions.
Materials and methods: A cross sectional analytic study was done in the Radiology Department,
Oncology Teaching Hospital, Baghdad Medical City, Baghdad, Iraq. The study period was one year
(February 2020 to January 2021). The study included 42 female patients with suspicious breast
lesions in the group BI-RAD 4 by mammography and US. Shear wave elastography was done for
all patients. The final diagnosis of all breast lesions were done by fine needle aspiration cytology or
true cut biopsy or excisional biopsy.
Results: The final histological diagnosis showed that 23 (54.8%) of study patients were with benign
breast lesions. There was a statistically significant association between the quality of SWE and
histopathological diagnosis as the proportion of malignant breast lesions was significantly higher
among the patients with score 5 (homogenous dark blue) images (85.7%, P= 0.004). Subjectts with
malignant lesions had a significantly higher mean of E-mean SWV than those with benign lesions
(133.8 versus 75.47 kPa, P = 0.001). The best cut point of E-mean SWV was 83 kPa (E-mean
SWV > 83 kPa is predictive for malignant lesion of breast) with 89.5% sensitivity, 60.9% specificity,
and 73.8% accuracy.
Conclusion: SWE have a significant diagnostic value in differentiation of BI-RADS IV breast
lesions into benign and malignant in both qualitative and quantitative patterns. The best cut off
value in SWE is 83 KPa for E-mean.
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