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Combination of shear-wave elastography and color Doppler: Feasible method to avoid unnecessary breast excision of fibroepithelial lesions diagnosed by core needle biopsy
BACKGROUND: We evaluated shear-wave elastography (SWE) and color Doppler ultrasonography (US) features for fibroepithelial lesions (FELs), and to evaluate their utility to differentiate fibroadenomas (FAs) and phyllodes tumors (PTs). METHODS: This retrospective study included 67 FELs pathologically...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5417487/ https://www.ncbi.nlm.nih.gov/pubmed/28472030 http://dx.doi.org/10.1371/journal.pone.0175380 |
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author | Kim, Ga Ram Choi, Ji Soo Han, Boo-Kyung Ko, Eun Young Ko, Eun Sook Hahn, Soo Yeon |
author_facet | Kim, Ga Ram Choi, Ji Soo Han, Boo-Kyung Ko, Eun Young Ko, Eun Sook Hahn, Soo Yeon |
author_sort | Kim, Ga Ram |
collection | PubMed |
description | BACKGROUND: We evaluated shear-wave elastography (SWE) and color Doppler ultrasonography (US) features for fibroepithelial lesions (FELs), and to evaluate their utility to differentiate fibroadenomas (FAs) and phyllodes tumors (PTs). METHODS: This retrospective study included 67 FELs pathologically confirmed (49 FAs, 18 PTs). B-mode US, SWE and color Doppler US were performed for each lesion. Mean elasticity (E(mean)), maximum elasticity (E(max)), and vascularity were determined by SWE and Doppler US. Diagnostic performances were calculated to differentiate FAs and PTs. Equivocal FELs diagnosed by core needle biopsy (CNB) were further analyzed. RESULTS: Median E(mean) and E(max) were significantly lower for FAs than PTs (E(mean), 15.7 vs. 66.7 kPa; E(max), 21.0 vs. 76.7 kPa, P<0.01). Low vascularity (0–1 vessel flow) on color Doppler US were more frequent in FAs than in PTs (P<0.01). SWE showed significantly higher specificities (E(mean) >43.9 kPa, 89.8%; E(max) >46.1 kPa, 79.6%) than B-mode US (42.9%) (P<0.01) for differentiating PTs from FAs. Other diagnostic values of SWE and overall diagnostic values of Doppler US were not significantly different from B-mode US (P>0.05). The combination of SWE and Doppler US with ‘E(mean)>43.9 kPa or high vascularity (≥2 vessel flows)’ showed a higher area under the curve (0.786 vs. 0.687) and higher diagnostic values than B-mode US (sensitivity, 100 vs. 94.4%; specificity, 57.1 vs. 42.9%; positive predictive value, 46.2 vs. 37.8%; negative predictive value, 100 vs. 95.5%), without statistical significance (P>0.05). Of the 30 equivocal FELs, all lesions with ‘E(mean)≤43.9 kPa and low vascularity (0–1 vessel flow)’ (23.3%, 7/30) were finally confirmed as FAs by excision. CONCLUSION: FAs have a tendency to have less stiffness and lower vascularity than PTs. Combined SWE and color Doppler US may help patients with equivocal FELs diagnosed by CNB avoid unnecessary excision. |
format | Online Article Text |
id | pubmed-5417487 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-54174872017-05-14 Combination of shear-wave elastography and color Doppler: Feasible method to avoid unnecessary breast excision of fibroepithelial lesions diagnosed by core needle biopsy Kim, Ga Ram Choi, Ji Soo Han, Boo-Kyung Ko, Eun Young Ko, Eun Sook Hahn, Soo Yeon PLoS One Research Article BACKGROUND: We evaluated shear-wave elastography (SWE) and color Doppler ultrasonography (US) features for fibroepithelial lesions (FELs), and to evaluate their utility to differentiate fibroadenomas (FAs) and phyllodes tumors (PTs). METHODS: This retrospective study included 67 FELs pathologically confirmed (49 FAs, 18 PTs). B-mode US, SWE and color Doppler US were performed for each lesion. Mean elasticity (E(mean)), maximum elasticity (E(max)), and vascularity were determined by SWE and Doppler US. Diagnostic performances were calculated to differentiate FAs and PTs. Equivocal FELs diagnosed by core needle biopsy (CNB) were further analyzed. RESULTS: Median E(mean) and E(max) were significantly lower for FAs than PTs (E(mean), 15.7 vs. 66.7 kPa; E(max), 21.0 vs. 76.7 kPa, P<0.01). Low vascularity (0–1 vessel flow) on color Doppler US were more frequent in FAs than in PTs (P<0.01). SWE showed significantly higher specificities (E(mean) >43.9 kPa, 89.8%; E(max) >46.1 kPa, 79.6%) than B-mode US (42.9%) (P<0.01) for differentiating PTs from FAs. Other diagnostic values of SWE and overall diagnostic values of Doppler US were not significantly different from B-mode US (P>0.05). The combination of SWE and Doppler US with ‘E(mean)>43.9 kPa or high vascularity (≥2 vessel flows)’ showed a higher area under the curve (0.786 vs. 0.687) and higher diagnostic values than B-mode US (sensitivity, 100 vs. 94.4%; specificity, 57.1 vs. 42.9%; positive predictive value, 46.2 vs. 37.8%; negative predictive value, 100 vs. 95.5%), without statistical significance (P>0.05). Of the 30 equivocal FELs, all lesions with ‘E(mean)≤43.9 kPa and low vascularity (0–1 vessel flow)’ (23.3%, 7/30) were finally confirmed as FAs by excision. CONCLUSION: FAs have a tendency to have less stiffness and lower vascularity than PTs. Combined SWE and color Doppler US may help patients with equivocal FELs diagnosed by CNB avoid unnecessary excision. Public Library of Science 2017-05-04 /pmc/articles/PMC5417487/ /pubmed/28472030 http://dx.doi.org/10.1371/journal.pone.0175380 Text en © 2017 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kim, Ga Ram Choi, Ji Soo Han, Boo-Kyung Ko, Eun Young Ko, Eun Sook Hahn, Soo Yeon Combination of shear-wave elastography and color Doppler: Feasible method to avoid unnecessary breast excision of fibroepithelial lesions diagnosed by core needle biopsy |
title | Combination of shear-wave elastography and color Doppler: Feasible method to avoid unnecessary breast excision of fibroepithelial lesions diagnosed by core needle biopsy |
title_full | Combination of shear-wave elastography and color Doppler: Feasible method to avoid unnecessary breast excision of fibroepithelial lesions diagnosed by core needle biopsy |
title_fullStr | Combination of shear-wave elastography and color Doppler: Feasible method to avoid unnecessary breast excision of fibroepithelial lesions diagnosed by core needle biopsy |
title_full_unstemmed | Combination of shear-wave elastography and color Doppler: Feasible method to avoid unnecessary breast excision of fibroepithelial lesions diagnosed by core needle biopsy |
title_short | Combination of shear-wave elastography and color Doppler: Feasible method to avoid unnecessary breast excision of fibroepithelial lesions diagnosed by core needle biopsy |
title_sort | combination of shear-wave elastography and color doppler: feasible method to avoid unnecessary breast excision of fibroepithelial lesions diagnosed by core needle biopsy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5417487/ https://www.ncbi.nlm.nih.gov/pubmed/28472030 http://dx.doi.org/10.1371/journal.pone.0175380 |
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