Abstract
BackgroundThis study is to examine the feasibility of shear wave elastography (SWE) anisotropy in assessing the prognosis of breast cancer.MethodsWe enrolled 119 breast cancer patients from January 2017 to October 2019. SWE was performed before operation. Emax (maximum elasticity value), Emean (average elasticity value), Esd (standard deviation of the lesion elasticity value), Eratio (elasticity value of adipose tissue), anisotropy coefficient and difference were recorded. After operation, we collected clinical pathological data, and performed immunohistochemistry and real-time PCR tests on CD44, CD24, E-cadherin, β-catenin, vimentin and N-cadherin. Finally, we analyzed the correlation among parameters of SWE, anisotropy and clinicopathology, and markers of CSCs (cancer stem cells) and EMT (epithelial-mesenchymal transition).ResultsEmax, Emean and Esd of the cross section were higher than those of the longitudinal section. Breast cancer with a higher elastic modulus was often accompanied by a hyperechoic halo, which was manifested as mixed echo and post-echo attenuation, and was accompanied by a higher BI-RADS (breast imaging reporting and data system) classification. When breast cancer had hyperechoic halo and weakened posterior echo, SWE of the lesion showed more obvious anisotropy. In addition, larger diameter of the longitudinal section indicated higher stiffness of the cross section. Correlation analysis showed that E-cadherin was negatively correlated with SWE in longitudinal section. CD44, N-cadherin, β-catenin were positively correlated with SWE in longitudinal and cross sections. Vimentin and CD24 had no correlation with SWE parameters.ConclusionSWE of breast cancer is anisotropic. The cross-sectional SWE is better than the longitudinal SWE, Emax is better than Emean, the anisotropy of SWE is better than SWE, and the anisotropy factor is better than the anisotropy difference.
Highlights
This study is to examine the feasibility of shear wave elastography (SWE) anisotropy in assessing the prognosis of breast cancer
The SWE of breast cancer is anisotropic In order to clarify whether there is anisotropy in SWE of breast cancer, we first explored the difference of SWE parameters in longitudinal and cross sections
The results showed that the Maximum elasticity value (Emax), Average elasticity value (Emean) and Standard deviation of the lesion elasticity value (Esd) of all the crosssection lesions were significantly higher than the longitudinal section (P < 0.05), in which Emax: (139.87 ± 92.64) kPa vs. (133.28 ± 90.80) kPa, P = 0.001; Emean: (45.22 ± 26.54) kPa vs. (42.65 ± 24.92) kPa, P = 0.001; Esd: (15.971 ± 9.096) kPa vs. (18.806 ± 14.482) kPa, P = 0.0161
Summary
This study is to examine the feasibility of shear wave elastography (SWE) anisotropy in assessing the prognosis of breast cancer. Ultrasonic images are affected by uncertainties and/or inaccuracies of various kinds which, among other things, determine an extremely low quality grayscale image contrast. This contrast has been treated by using fuzzy techniques precisely [6, 7]. Shear wave elastography (SWE) is a stable ultrasonic elastic technology with high repeatability and is independent of external pressure, which reflects the stiffness of the tissue to a certain extent [8]. A method to non-invasively assess the prognosis of breast cancer before surgery is needed
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