The application of 3-dimensional shear wave elastography in diagnosis of malignant and benign breast masses

Abstract

Objective To investigate the application value of three-dimensional shear wave elastography(3D-SWE) in diagnosis of malignant and benign breast masses. Methods Sixty-seven patients with total 96 masses diagnosed by ultrasound and verified with surgical pathological analysis were selected. The masses were divided into benign group (54 masses) and malignant group (42 masses). The quantitative diagnosis was performed using two-dimensional shear wave elastography(2D-SWE) and 3D-SWE to evaluate the hardness of the masses. Receiver operating characteristic (ROC) curves of 2D-SWE and 3D-SWE were drawn to calculate the sensibility and specificity in diagnosis of breast masses. The qualitative diagnosis was performed according to the elastic color image classification to classify the elastic images of the lesions into type Ⅰ-Ⅳ. Results The quantitative diagnosis: ① There were significant differences in Emean, Emax and SD on planes of 2D-SWE and three orthogonal planes of 3D-SWE between the two groups (P 0.05); ③ Emean, Emax and SD on planes of 2D-SWE and three orthogonal planes of 3D- SWE both exhibited high diagnostic performance.However, there was no significant difference in Emean, Emax and SD between 2D-SWE and 3D-SWE (P>0.05). The qualitative diagnosis of elastic color mode: type Ⅰ and type Ⅱ account for most planes of 2D-SWE and three orthogonal planes of 3D-SWE in benign masses, while type Ⅲ and type Ⅳ account for most in malignant masses.Among the malignant group, type Ⅲ on the 3D-SWE coronal planes was significantly more than other three types (P<0.05). Conclusions For quantitative diagnosis, 2D-SWE and 3D-SWE are both beneficial to differentiate benign from malignant masses, but there is no difference in diagnostic efficacy; for qualitative diagnosis, 3D-SWE can provide more diagnostic information than 2D-SWE, especially on the coronal planes of 3D-SWE. Key words: Ultrasonography, mammary; Breast neoplasms; Shear wave elastography