Quantitative heterogeneity assessment of breast lesions with shear wave elastography (SWE) in differentiation of benign and malignant lesions

Congress:

ECR 2019

Poster Number:

C-3349

Type:

Scientific Exhibit

Keywords:

Breast, Ultrasound physics, Elastography, Ultrasound, Diagnostic procedure, Cancer

Authors:

H. Y. L. Sinn, J. C. M. Sitt, C. Y. Fong, C. Y. Lui; Hong Kong/HK

DOI:

10.26044/ecr2019/C-3349

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3349

Fig. 1: Elasticity parameters located on the right side of the image during acquisition

Fig. 3: Comparison between the benign and malignant group

Fig. 6: The AUC of ROC of different elasticity parameters

Aims and objectives

Handheld ultrasound as an adjunct to mammography in dense breast patients has been proven to improve cancer detection rate (especially invasive cancers), more early stage cancers [1-3], yet with higher false positives and increased biopsy rate [4] . New imaging technique have been developed in order to improve the performaces of ultrasound. Elastography is the imaging modality based on tissue sitffness / hardness. Shear wave eleastography (SWE) allows both qualitative and quantitative assessment of elasticityparameters which may improve the diagnostic accuracy. This study would like...

Methods and materials

This is a retrospective study of patients who attended our centre with both diagnostic ultrasound of breast lesions including SWE and ultrasound-guided core biopsy performed. All studies include B-mode (two orthogonal views with maximal dimension), Doppler (at least one view) and elastography images (at least one view). Lesions characteristics according to BI-RADS lexicon, elasticity parameters [Emean, Emax, Emin,ESD(as parameter reflecting heterogeneity)] in kPa, region of interest (ROI) size, lesion depths, positioning of ROI, and the pathological diagnosis were recorded. All examinations are performed with Supersonic...

Results

Results Interim analysis of 258 breast lesions from the period November 2017 - June 2018 is performed. A total of 199 benign and 59 malignant lesions were analysed, with the result of lesion types listed in Fig.2. The age of the group with benign lesions (mean = 43.48 CI 95%41.9-45.0) is significant lower than the group with malignancy (mean = 52.5 CI 95% 49.7 - 55.4) (see Fig.3). The Emean, Emaxand ESD and the lesion-to-fat ratio (elasticity ratio)of the malignant group were significantly higher than...

Conclusion

Quantitative assessment of lesion heterogeneity with ESDin addition to Emeanand Emaxmay be considered as supplementary parameter to conventional ultrasound findings to improve differentiation of benign and malignant lesion.

Personal information

References

1. Parris T. Wakefield D, Frimmer H.Real world performance of screening breast ultrasound following enactment of Connecticut Bill 458. Breast J. 2013 Jan-Feb;19(1):64-70. 2. Weigert JM. The Connecticut Experiment; The Third Installment: 4 Years of Screening Women with Dense Breasts with Bilateral Ultrasound.Breast J. 2017 Jan;23(1):34-39. 3. Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology. 2002;225:165–175 4. Berg WA, Blume JD,...