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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
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.
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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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