Comparing Performance of Combinations of Shear Wave Elastography and B-Mode Ultrasound in Diagnosing Breast Masses: Is It Influenced by Mass Size?

Abstract

We determined the diagnostic performance of combinations of shear wave elastography (SWE) and B-mode ultrasound (US) in differentiating malignant from benign breast masses, and we investigated whether performance is affected by mass size. In this prospective study of 315 consecutive patients with 326 breast masses, US and SWE were performed before biopsy. Masses were categorized into two subgroups on the basis of mass size (≤15 mm and >15 mm), and the optimal thresholds for the SWE parameters were determined for each subgroup using receiver operating characteristic curves. The combination proposed here achieved an area under the receiver operating characteristic curve of 0.943, 95.00% sensitivity and 81.18% specificity, which approximated the diagnostic performance of US alone. The performance of the combinations using the subgroups' thresholds did not differ significantly from those based on the entire study group's thresholds, but the optimal thresholds were higher in the subgroup of larger masses. Further research is needed to determine whether mass size affects the performance of combinations of SWE and US.

Keywords: Breast Imaging Reporting and Data System; Breast masses; Diagnosis; Shear wave elastography; Ultrasonography.