Strain Elastography Combined With Shear-wave Elastography In Differential Diagnosis Of Benign And Malignant Breast Tumors

Objective To explore the diagnostic efficiency of strain elastography(SE)combined with shear-wave elastography(SWE)in differentiating benign form malignant breast lesions.Methods From January 2017 to December 2018,164 consecutive women with breast lesions which were confirmed by pathology were collected.All the patients underwent the conventional ultrasound,SE,and SWE examinations before the surgery,and the SE and SWE parameters were calculated.The breast lesions were divided using breast imaging reporting and data system(BI-RADS)based on the conventional US examination(score 1-3,benign lesion;score 4-5,malignant lesion).Using the pathologic results as the gold standard,the receiver operator characteristic(ROC)curve was used to evaluate the diagnostic performance of SE parameters,SWE parameters,and SE combined with SWE parameters.The areas under the ROC curves(AUC),sensitivity,specificity,and accuracy were calculated.Z test was used to compared the AUCs.Results In SE,the ROC analysis shown that the the sensitivity,specificity,and accuracy of SE were 74.5%,87.1%and 82.9%,when the score of BI-RADS was between 3 and 4.When the optimal cut value of SR was 1.76,the sensitivity,specificity and accuracy of diagnosis of breast tumor were 59.5%,88.2%and 78.8%.In the SWE,the ROC showed that when the Emax was 140.28 kPa and the sensitivity,specificity and accuracy of Emax were 71.0%,84.1%and 82.3%respectively.When the Emean was 33.34 kPa,the sensitivity,specificity and accuracy for the differential diagnosis were 83.9%,59.4%,and 76.0%.When the Esd was 22.27 kPa,its sensitivity,specificity and accuracy were 61.3%,85.5%,and 71.1%.When the Eratio threshold was 2.60,the sensitivity,specificity and accuracy were 64.5%,50.7%,and 62.2%.When the shear wave elastic modulus was≤140Kpa,sensitivity,specificity and accuracy for the diagnosis is 78.9%,85.7%,and 84.1%,respectively.When strain combined with shear wave elastography,their sensitivity,specificity and accuracy of differential diagnosis of benign and malignant breast lesions were 64.9%,84.5%,and 86.2%,respectively.Conclusion Strain and shear-wave elastography were helpful to diagnose and differential diagnose of breast lesions.The combination of the two techniques,obviously improved the diagnostic efficiency of each technique.