A novel two-dimensional quantitative shear wave elastography to make differential diagnosis of breast lesions: Comprehensive evaluation and influencing factors
Affiliations: Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Yanchangzhong, Shanghai, China
Correspondence:
[*]
Corresponding author: Rong Wu, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yanchangzhong road, Shanghai 200072, China. Tel.: +86 021 66307539; E-mail: wurong7111@163.com.
Abstract: BACKGROUND: Virtual touch imaging quantification (VTIQ), a form of shear wave elastography, may help in the diagnosis of breast lesions. OBJECTIVE: We aimed to evaluate the diagnostic performance of combined VTIQ and conventional ultrasound (US), and assess the factors influencing VTIQ measurement. METHODS: From September 2014 to December 2014, 162 patients with breast lesions were examined by US and VTIQ to assess shear wave speed (SWS) and morphological characteristics (lesion shape, orientation, margin and echo pattern). The sensitivity, specificity and accuracy of VTIQ, US and VTIQ+US for the diagnosis of breast lesions was evaluated in comparison to pathological results. Factors influencing deviations in SWS measurements were assessed by logistic regression. RESULTS: The SWS cut-off between malignant and benign lesions was 3.73 m/s. The sensitivity, specificity and accuracy were: 98.07%, 55.96%, and 69.57% for US; 76.92%, 78.89% and 78.26% for VTIQ; and 98.07%, 84.40% and 88.82% for US+VTIQ. The two factors that influenced the SWS results were the lesion margin (odds ratio [OR], 16.363; 95% confidence interval [CI], 3.220–29.020) and vascularity (OR, 6.712; 95% CI, 1.358–9.072). CONCLUSIONS: The lesion margin and vascularity could affect the measurement of SWS as well as the experience of examiner. However, VTIQ is still a reliable method that provides valuable information in the differential diagnosis of breast lesions, and may reduce unnecessary biopsies.
Keywords: Elastography, breast cancer, VTIQ, ultrasound
