Diagnostic Value Of Elastic Heterogeneity Analysis Based On SWE Technology In Differentiating Benign From Malignant Breast Leisions

Objective:To explore the application value of elastic heterogeneity analysis based on SWE technology in differentiating benign from malignant breast leisions and to determine the optimal parameter.Methods:From August 2019 to October 2020,Totally 146 consecutive women with 150breast masses were enrolled in our study,who underwent SWE examination before surgical excision or US-guided core needle biopsy in the First Hospital of Shanxi Medical University.All selected masses were assessed by conventional ultrasound and2D SWE.The results of BI-RADS classiffication and elastic parameters of leisions were obtained,the Stiffness Gradient(SG)was caculated.The qualitative features of the masses were analysed using both the four-colour overlay pattern and the three-colour overlay pattern(Ehomo).Based on the pathological results,the diagnostic efficacy of SWE quantitative heterogeneity parameters and colour overlay feature classifications in identifying breast leisions were assessed according to ROC curves.The areas under the ROC curves were compared using the Z-test.Afterwards,The diagnostic power of optimal parameter was evatulated in correcting BI-RADS 3-5 category of breast leisions.Results:(1)The malignant breast masses had higher SWE values than those of benign masses,including SG,Esd,Emax,Emean,with statistical significance(P<0.001).The AUC of SG(0.925)was the highest among elasticity values with the optimal threshold of120.2k Pa.(2)The four-colour overlay pattern showed better diagnostic performance than Ehomo features in the diagnosis of breast lesions,with a statistically significant difference between the AUC of them(P<0.05).(3)The SG,Esd all exhibited significantly high correlation with the four-colour overlay pattern(r_s=0.967,0.843,P<0.001).In addition,The AUC value of SG in differential diagnosis of benign and malignant breast lesions is higher than that of Esd or four-colour overlay pattern classification,the differences are statistically significant(P<0.05).(4)The BI-RADS classification adjusted by SG exhibited better specificity and accuracy of clinical diagnosis in breast leisions than BI-RADS itself(P<0.05).Conclusion:(1)SG is a valuable diagnostic parameter for quantifying elastic heterogeneity,SG showed better discriminatory ability than SD in distinguishing benign from malignant breast lesions.(2)The qualitative colour overlay features were significantly correlated with SG value,which could be quantified by SG to better assess elastic heterogeneity of breast masses.(3)The BI-RADS classification adjusted by SG exhibited better ability in terms of the differential diagnosis of breast leisions than before,which could assist in reducing the unnecessary biopsies of of breast masses.