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

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 (ESDU) measured on the grayscale image and the standard deviation (ESDE) 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 ESDE for diagnosing benign and malignant breast masses was significantly higher than that of ESDU (90.2% vs 82.6%, P=0.023). In 2D SWE, the AUC of ESDE in diagnosing benign and malignant breast masses was significantly higher than that of ESDU (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 ESDE or ESDU. 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 ESDU 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 ESDE has better clinical value than ESDU. Key words: Breast diseases; Ultrasonography; Elasticity imaging techniques