Added value of shear-wave elastography for evaluation of breast masses detected with screening US imaging

Su Hyun Lee, Jung Min Chang, Won Hwa Kim, Min Sun Bae, Mirinae Seo, Hye Ryoung Koo, A. Jung Chu, Hye Mi Gweon, Nariya Cho, Woo Kyung Moon

Research output: Contribution to journalReview article

60 Scopus citations


Purpose: To evaluate the additional value of shear-wave elastography (SWE) to B-mode ultrasonography (US) and to determine an appropriate guideline for the combined assessment of screening US-detected breast masses.

Materials and Methods: This study was conducted with institutional review board approval, and written informed consent was obtained. From March 2010 to February 2012, B-mode US and SWE were performed in 159 US-detected breast masses before biopsy. For each lesion, Breast Imaging Reporting and Data System (BI-RADS) category on B-mode US images and the maximum stiffness color and elasticity values on SWE images were assessed. A guideline for adding SWE data to B-mode US was developed with the retrospective cohort to improve diagnostic performance in sensitivity and specificity and was validated in a distinct prospective cohort of 207 women prior to biopsy.

Results: Twenty-one of 159 masses in the development cohort and 12 of 207 breast masses in the validation cohort were malignant. In the development cohort, when BI-RADS category 4a masses showing a dark blue color or a maximum elasticity value of 30 kPa or less on SWE images were downgraded to category 3, specificity increased from 9.4% (13 of 138) to 59.4% (82 of 138) and 57.2% (79 of 138) (P < .001), respectively, without loss in sensitivity (100% [21 of 21]). In the validation cohort, specificity increased from 17.4% (34 of 195) to 62.1% (121 of 195) and 53.3% (104 of 195) (P < .001) respectively, without loss in sensitivity (91.7% [11 of 12]).

Conclusion: The addition of SWE to B-mode US improved diagnostic performance with increased specificity for screening USdetected breast masses. BI-RADS category 4a masses detected at US screening that showed a dark blue color or a maximum elasticity value of 30 kPa or less on SWE images can be safely followed up instead of performing biopsy.

Original languageEnglish
Pages (from-to)61-69
Number of pages9
Issue number1
StatePublished - 1 Oct 2014

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