Two-dimensional shear wave elastography with two different systems for the diagnosis of breast lesions

Article type: Research Article

Authors: Yu, Ji-Feng^{a; b; c; 1} | Zhang, Shen^{a; b; c; 1} | Yin, Hao-Hao^{b; c} | Zhou, Bang-Guo^{b; c; *} | Pu, Yin-Ying^{b; c} | Fang, Yan^{b; c} | Du, Dou^{b; c} | Zhang, Yan^{b; c} | Xu, Hui-Xiong^{a; b; c; *}

Affiliations: [a] Department of Medical Ultrasound, Shanghai Tenth Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai, P.R. China | [b] Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People’s Hospital; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University. Shanghai, P.R. China | [c] Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment; National Clinical Research Center for Interventional Medicine, Shanghai, P.R. China

Correspondence: [*] Corresponding authors: Hui-Xiong Xu, MD, PhD, Department of Medical Ultrasound, Shanghai Tenth Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai 200072, P. R. China, Tel.: +86 2166307539; E-mail: xuhuixiong2022@126.com and Bang-Guo Zhou, MD, PhD, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China. Tel.: +86 18267856130; E-mail: 913565417@qq.com.

Note: [1] Equal Contributors.

Abstract: BACKGROUND:Two-dimensional (2D) - shear wave elastography (SWE) has made promising advances in the diagnostic of breast lesions. However, few studies have assessed whether the diagnostic effectiveness of different platforms employing 2D-SWE is equal or different. OBJECTIVE:To compare the diagnostic effectiveness of 2D-SWE techniques from two different systems in differentiating malignant breast lesions from benign ones. METHODS:A total of 84 breast lesions were retrospectively analyzed by experienced radiologists using 2D-SWE on two ultrasound systems, i.e. system-1 (LOGIQ E9 system, GE Healthcare, Wauwatosa, WI, USA), and system-2 (Aixplorer US system, SuperSonic Imagine, Aix-en-Provence, France). Qualitative and quantitative parameters including color sign, the maximum elasticity modulus values (E-max), the mean elasticity modulus values (E-mean) and standard deviation (E-sd) of elasticity modulus values in two 2D-SWE systems were analyzed. The diagnostic performance between system-1 and system-2 were evaluated in terms of the areas under the receiver operating characteristic curves (AUROCs). RESULTS:Among the 84 lesions in this study, 66 (78.6%) were benign and 18 (21.4%) were malignant. E-max in system-1 showed the best diagnostic performance with a cut-off value of 174.5 kPa with the associated sensitivity and specificity of 100.0% and 80.3% respectively. Meanwhile, E-sd in system-2 displayed the best diagnostic performance with a cut-off value of 12.7 kPa, with the associated sensitivity and specificity of 94.4% and 80.3% respectively. The diagnostic performance of the two 2D-SWE systems was not statistically different according to receiver operating characteristic curve (ROC) analysis of E-max, E-mean, and E-sd. CONCLUSION:For identifying breast lesions, system-1 and system-2 appear to be similar in diagnostic performance. However, different cut-off values for different parameters might be selected to obtain the best diagnostic performance for the two 2D-SWE systems.

Keywords: Shear wave elastography, breast, ultrasound

DOI: 10.3233/CH-221471

Journal: Clinical Hemorheology and Microcirculation, vol. 82, no. 1, pp. 53-62, 2022