Application of three-dimensional quantitative elastography in differentiating benign and malignant breast masses

doi:10.3877/cma.j.issn.1672-6448.2019.08.007

Abstract

Abstract:

Objective

To evaluate the application value of three-dimensional (3D) shear wave elastography (SWE) in differentiating benign and malignant breast masses, and compare it with two-dimensional (2D) SWE.

Methods

One hundred and forty-nine breast masses in 128 female patients admitted to the First Affiliated Hospital of Harbin Medical University from August 2015 to June 2016 were examined by B-mode ultrasound (US), 2D and 3D SWE. All cases were confirmed by pathology. The diagnostic performance of SWE quantitative parameters, conventional 2D ultrasound, and conventional 2D ultrasound combined with SWE in diagnosing benign and malignant breast masses was assessed by receiver operating characteristic (ROC) curve analysis. The calculated areas under the curves (AUCs) were compared using the Z-test, and sensitivities and specificities were calculated and compared using the McNemar test.

Results

In 3D SWE, the AUC of the standard deviation (E_SD^U) measured on the grayscale image and the standard deviation (E_SD^E) measured on the elastic image for diagnosing benign and malignant breast masses were 0.887 and 0.909, respectively, which had no significant difference (P>0.05). In 3D SWE, the specificity of E_SD^E for diagnosing benign and malignant breast masses was significantly higher than that of E_SD^U (90.2% vs 82.6%, P=0.023). In 2D SWE, the AUC of E_SD^E in diagnosing benign and malignant breast masses was significantly higher than that of E_SD^U (0.933 vs 0.908, P=0.04). In comparison of 2D and 3D SWE data, no significant differences were found in AUCs for either E_SD^E or E_SD^U. The AUCs of conventional 2D ultrasound combined with 2D and 3D SWE in diagnosing benign and malignant breast masses were significantly higher than that of conventional 2D ultrasound (P<0.05). Except for the E_SD^U in 3D SWE, the specificities of other conventional 2D ultrasound data combined with 2D and 3D SWE in diagnosing benign and malignant breast masses were significantly higher than that of conventional 2D ultrasound (P<0.05).

Conclusion

3D SWE has good diagnostic performance in differentiating benign and malignant breast masses, and the measurement of E_SD^E has better clinical value than E_SD^U.

Key words: Breast diseases, Ultrasonography, Elasticity imaging techniques

Jie Tian, Qianqi Liu, Xi Wang, Changjun Wu. Application of three-dimensional quantitative elastography in differentiating benign and malignant breast masses[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2019, 16(08): 586-591.

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Figures/Tables 6

References 20

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乳腺结节	E_SD^U			E_SD^E			E_max
乳腺结节	二维SWE	三维SWE	P值	二维SWE	三维SWE	P值	二维SWE	三维SWE	P值
恶性	17.8（12.3，25.2）	17.1（12.0，26.1）	0.651	22.8（16.2，30.8）^a	20.6（16.53，28.6）^a	0.479	148.9（102，208.4）	191.9（168.5，230.3）	<0.001
良性	6.4（4.5，8.5）	7.18（5.4，8.8）	0.0307	7.07（5.2，9.8）^a	7.9（6.3，10.7）^a	0.0235	42.9（30.5，57.2）	85.4（65.9，121.2）	<0.001
P值	<0.001	<0.001	?	<0.001	<0.001	?	<0.001	<0.001	?

乳腺结节	E_SD^U			E_SD^E			E_max
乳腺结节	二维SWE	三维SWE	P值	二维SWE	三维SWE	P值	二维SWE	三维SWE	P值
恶性	17.8（12.3，25.2）	17.1（12.0，26.1）	0.651	22.8（16.2，30.8）^a	20.6（16.53，28.6）^a	0.479	148.9（102，208.4）	191.9（168.5，230.3）	<0.001
良性	6.4（4.5，8.5）	7.18（5.4，8.8）	0.0307	7.07（5.2，9.8）^a	7.9（6.3，10.7）^a	0.0235	42.9（30.5，57.2）	85.4（65.9，121.2）	<0.001
P值	<0.001	<0.001	?	<0.001	<0.001	?	<0.001	<0.001	?

参数	阈值（kPa）		AUC			敏感度（%）			特异度（%）
参数	二维SWE	三维SWE	二维SWE	三维SWE	P值	二维SWE	三维SWE	P值	二维SWE	三维SWE	P值
E_SD^U	10.6	9.8	0.908	0.887	0.369	82.4	87.7	0.248	89.1	82.6	0.041
E_SD^E	13.7	13.1	0.933^a	0.909	0.154	84.2	80.7	0.479	93.4	90.2^a	0.248
E_max	79.4	154.0	0.943^b	0.904	0.010	85.9	82.4	0.479	95.6	90.2	0.074

参数	阈值（kPa）		AUC			敏感度（%）			特异度（%）
参数	二维SWE	三维SWE	二维SWE	三维SWE	P值	二维SWE	三维SWE	P值	二维SWE	三维SWE	P值
E_SD^U	10.6	9.8	0.908	0.887	0.369	82.4	87.7	0.248	89.1	82.6	0.041
E_SD^E	13.7	13.1	0.933^a	0.909	0.154	84.2	80.7	0.479	93.4	90.2^a	0.248
E_max	79.4	154.0	0.943^b	0.904	0.010	85.9	82.4	0.479	95.6	90.2	0.074

方法		AUC	敏感度（%）	特异度（%）
常规二维超声BI-RADS分类		0.883	91.2	78.3
常规二维超声联合二维SWE		?	?	?
?	E_SD^U	0.941^a	84.2	93.5^a
?	E_SD^E	0.948^a	87.7	94.6^a
?	E_max	0.956^a	86.0	94.6^a
常规二维超声联合三维SWE		?	?	?
?	E_SD^U	0.935^a	91.2	81.5
?	E_SD^E	0.938^a	82.5	93.5^a
?	E_max	0.936^a	80.7	96.7^a

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