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Confirmed value of shear wave elastography for ultrasound characterization of breast masses using a conservative approach in Chinese women: a large-size prospective multicenter trial
PURPOSE: This study aimed to investigate the value of shear wave elastography (SWE) for characterization of breast masses in a Chinese population. PATIENTS AND METHODS: Two thousand two hundred seventy-three women consented to be prospectively enrolled for the characterization of breast masses with...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6187919/ https://www.ncbi.nlm.nih.gov/pubmed/30349377 http://dx.doi.org/10.2147/CMAR.S174690 |
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author | Lin, Xi Chang, Cai Wu, Changjun Chen, Qin Peng, Yulan Luo, Baoming Tang, Lina Li, Jing Zheng, Jihui Zhou, Ruhai Cui, Guanghe Li, Ao Wang, Xuemei Qian, Linxue Zhang, Jianxing Wen, Chaoyang Gay, Joel Zhang, Huili Li, Anhua Chen, Yaling |
author_facet | Lin, Xi Chang, Cai Wu, Changjun Chen, Qin Peng, Yulan Luo, Baoming Tang, Lina Li, Jing Zheng, Jihui Zhou, Ruhai Cui, Guanghe Li, Ao Wang, Xuemei Qian, Linxue Zhang, Jianxing Wen, Chaoyang Gay, Joel Zhang, Huili Li, Anhua Chen, Yaling |
author_sort | Lin, Xi |
collection | PubMed |
description | PURPOSE: This study aimed to investigate the value of shear wave elastography (SWE) for characterization of breast masses in a Chinese population. PATIENTS AND METHODS: Two thousand two hundred seventy-three women consented to be prospectively enrolled for the characterization of breast masses with ultrasound and SWE. Breast masses were known from symptoms, palpability, and/or previous imaging screening with mammography and/or ultrasound. Correlation of SWE qualitative and quantitative features with malignancy risk and impact on diagnostic performance of combining SWE features were assessed, and the Breast Imaging Reporting and Data System (BI-RADS) scoring was calculated using histopathology as reference. RESULTS: Data of 2,262 masses (median size: 13 mm; range: 1.3–50) from 2,262 patients (median age: 43 years; range: 18–91) were investigated, of which 752 (33.3%) were malignant. Sensitivity and specificity of BI-RADS diagnosis were 97.5% (733/752) and 54.8% (827/1,510), respectively. By logistic regression, the combination of maximum elasticity (E(max)) measurements with BI-RADS assessments increased the area under the receiver operating characteristic curve from 0.908 (95% CI: 0.896–0.920) to 0.954 (95% CI: 0.944–0.962). Using E(max) of 30 kPa or lower to selectively downgrade BI-RADS 4a masses to follow-up, and E(max) of 160 kPa or higher to selectively upgrade BI-RADS 3 lesions to biopsy, specificity significantly increased from 54.8% (827/1,510) to 66.1% (998/1,510) (P<0.001) while sensitivity decreased nonsignificantly from 97.5% (733/752) to 96.9% (729/752) (P=0.2891). Positive predictive value for biopsy recommendation increased from 51.7% (733/1,417) to 58.7% (729/1,241) (P<0.001). CONCLUSION: Adding SWE maximum stiffness to BI-RADS 3 and BI-RADS 4a breast masses in a Chinese population increased significantly the specificity of breast ultrasonography, without significant change in sensitivity. |
format | Online Article Text |
id | pubmed-6187919 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-61879192018-10-22 Confirmed value of shear wave elastography for ultrasound characterization of breast masses using a conservative approach in Chinese women: a large-size prospective multicenter trial Lin, Xi Chang, Cai Wu, Changjun Chen, Qin Peng, Yulan Luo, Baoming Tang, Lina Li, Jing Zheng, Jihui Zhou, Ruhai Cui, Guanghe Li, Ao Wang, Xuemei Qian, Linxue Zhang, Jianxing Wen, Chaoyang Gay, Joel Zhang, Huili Li, Anhua Chen, Yaling Cancer Manag Res Original Research PURPOSE: This study aimed to investigate the value of shear wave elastography (SWE) for characterization of breast masses in a Chinese population. PATIENTS AND METHODS: Two thousand two hundred seventy-three women consented to be prospectively enrolled for the characterization of breast masses with ultrasound and SWE. Breast masses were known from symptoms, palpability, and/or previous imaging screening with mammography and/or ultrasound. Correlation of SWE qualitative and quantitative features with malignancy risk and impact on diagnostic performance of combining SWE features were assessed, and the Breast Imaging Reporting and Data System (BI-RADS) scoring was calculated using histopathology as reference. RESULTS: Data of 2,262 masses (median size: 13 mm; range: 1.3–50) from 2,262 patients (median age: 43 years; range: 18–91) were investigated, of which 752 (33.3%) were malignant. Sensitivity and specificity of BI-RADS diagnosis were 97.5% (733/752) and 54.8% (827/1,510), respectively. By logistic regression, the combination of maximum elasticity (E(max)) measurements with BI-RADS assessments increased the area under the receiver operating characteristic curve from 0.908 (95% CI: 0.896–0.920) to 0.954 (95% CI: 0.944–0.962). Using E(max) of 30 kPa or lower to selectively downgrade BI-RADS 4a masses to follow-up, and E(max) of 160 kPa or higher to selectively upgrade BI-RADS 3 lesions to biopsy, specificity significantly increased from 54.8% (827/1,510) to 66.1% (998/1,510) (P<0.001) while sensitivity decreased nonsignificantly from 97.5% (733/752) to 96.9% (729/752) (P=0.2891). Positive predictive value for biopsy recommendation increased from 51.7% (733/1,417) to 58.7% (729/1,241) (P<0.001). CONCLUSION: Adding SWE maximum stiffness to BI-RADS 3 and BI-RADS 4a breast masses in a Chinese population increased significantly the specificity of breast ultrasonography, without significant change in sensitivity. Dove Medical Press 2018-10-11 /pmc/articles/PMC6187919/ /pubmed/30349377 http://dx.doi.org/10.2147/CMAR.S174690 Text en © 2018 Lin et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Lin, Xi Chang, Cai Wu, Changjun Chen, Qin Peng, Yulan Luo, Baoming Tang, Lina Li, Jing Zheng, Jihui Zhou, Ruhai Cui, Guanghe Li, Ao Wang, Xuemei Qian, Linxue Zhang, Jianxing Wen, Chaoyang Gay, Joel Zhang, Huili Li, Anhua Chen, Yaling Confirmed value of shear wave elastography for ultrasound characterization of breast masses using a conservative approach in Chinese women: a large-size prospective multicenter trial |
title | Confirmed value of shear wave elastography for ultrasound characterization of breast masses using a conservative approach in Chinese women: a large-size prospective multicenter trial |
title_full | Confirmed value of shear wave elastography for ultrasound characterization of breast masses using a conservative approach in Chinese women: a large-size prospective multicenter trial |
title_fullStr | Confirmed value of shear wave elastography for ultrasound characterization of breast masses using a conservative approach in Chinese women: a large-size prospective multicenter trial |
title_full_unstemmed | Confirmed value of shear wave elastography for ultrasound characterization of breast masses using a conservative approach in Chinese women: a large-size prospective multicenter trial |
title_short | Confirmed value of shear wave elastography for ultrasound characterization of breast masses using a conservative approach in Chinese women: a large-size prospective multicenter trial |
title_sort | confirmed value of shear wave elastography for ultrasound characterization of breast masses using a conservative approach in chinese women: a large-size prospective multicenter trial |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6187919/ https://www.ncbi.nlm.nih.gov/pubmed/30349377 http://dx.doi.org/10.2147/CMAR.S174690 |
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