Abstract
To evaluate the diagnostic performance of a new two-dimensional shear wave speed (SWS) imaging (i.e. Toshiba shear wave elastography, T-SWE) in differential diagnosis of breast lesions. 225 pathologically confirmed breast lesions in 218 patients were subject to conventional ultrasound and T-SWE examinations. The mean, standard deviation and ratio of SWS values (m/s) and elastic modulus (KPa) on T-SWE were computed. Besides, the 2D elastic images were classified into four color patterns. The area under the receiver operating characteristic (AUROC) curve analysis was performed to evaluate the diagnostic performance of T-SWE in differentiation of breast lesions. Compared with other quantitative T-SWE parameters, mean value expressed in KPa had the highest AUROC value (AUROC = 0.943), with corresponding cut-off value of 36.1 KPa, sensitivity of 85.1%, specificity of 96.6%, accuracy of 94.2%, PPV of 87.0%, and NPV of 96.1%. The AUROC of qualitative color patterns in this study obtained the best performance (AUROC = 0.957), while the differences were not significant except for that of Eratio expressed in m/s (AUROC = 0.863) (P = 0.03). In summary, qualitative color patterns of T-SWE obtained the best performance in all parameters, while mean stiffness (36.05 KPa) provided the best diagnostic performance in the quantitative parameters.
Highlights
IntroductionPoint shear wave speed (SWS) measurement such as virtual touch tissue quantification (VTQ; Siemens Medical Solutions, Mountain View, CA, USA) can measure the SWS of tissue and several studies showed that point SWS measurement is useful in differentiation between benign and malignant breast lesions[10,11,12]
Three main types of 2D shear wave speed (SWS) imaging techniques are applied in clinical practice, which are shear wave elastography (SWE) from Super Sonic Imagine (SSI; Aix en Provence, France), virtual touch tissue imaging & quantification (VTIQ; Siemens Medical Solutions, Mountain View, CA, USA) and Toshiba SWE (T-SWE; Toshiba Medical System, Tochigi, Japan)
Shear wave imaging has better performance compared with SE in that it provides quantitative stiffness information of the target lesion
Summary
Point SWS measurement such as virtual touch tissue quantification (VTQ; Siemens Medical Solutions, Mountain View, CA, USA) can measure the SWS of tissue and several studies showed that point SWS measurement is useful in differentiation between benign and malignant breast lesions[10,11,12]. Three main types of 2D SWS imaging techniques are applied in clinical practice, which are shear wave elastography (SWE) from Super Sonic Imagine (SSI; Aix en Provence, France), virtual touch tissue imaging & quantification (VTIQ; Siemens Medical Solutions, Mountain View, CA, USA) and Toshiba SWE (T-SWE; Toshiba Medical System, Tochigi, Japan). The tissue stiffness on VTIQ is denoted by SWS distribution, which is expressed in m/s (range, 0.5–10 m/s) and has gained promising application in diagnosis of breast lesions[18,19,20]. This study was aimed to evaluate the diagnostic performance of qualitative and quantitative analyses for T-SWE in the differentiation of breast lesions
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