Department of Radiology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
Eur Radiol. 2017 Jan;27(1):7-15. doi: 10.1007/s00330-016-4359-6. Epub 2016 Apr 16.
To investigate whether mass stiffness measured by shear-wave elastography (SWE) can predict the histological upgrade of ductal carcinoma in situ (DCIS) confirmed through ultrasound (US)-guided core needle biopsy (CNB).
The institutional review board approved this study and informed consent was waived. A database search revealed 120 biopsy-confirmed DCIS in patients who underwent B-mode US and SWE prior to surgery. Clinicopathologic results, B-mode findings, size on US, and mean and maximum elasticity values on SWE were recorded. Associations between upgrade to invasive cancer and B-mode US findings, SWE information, and clinical variables were assessed using univariate, multivariate logistic regression, and multiple linear regression analysis.
The overall upgrade rate was 41.7 % (50/120). Mean stiffness value (P = .014) and mass size (P = .001) were significantly correlated with histological upgrade. The optimal cut-off value of mean stiffness value, yielding the maximal sum of sensitivity and specificity, was 70.7 kPa showing sensitivity of 72 % and specificity of 65.7 % for detecting invasiveness. Qualitative elasticity colour scores were significantly correlated with the histological upgrade, mammographic density, and B-mode category (P < .04).
Mean stiffness values evaluated through SWE can be utilized as a preoperative predictor of histological upgrade to invasive cancer in DCIS confirmed at US-guided needle biopsy.
• Higher stiffness values were noted in invasive cancer than DCIS. • Qualitative SWE colour scores significantly correlated with the histological upgrade. • Qualitative SWE colour scores had excellent interobserver agreement.
探究通过剪切波弹性成像（SWE）测量的质量刚性是否可预测经超声（US）引导的核心针活检（CNB）证实的导管原位癌（DCIS）的组织学升级。
机构审查委员会批准了本研究，且豁免了知情同意。数据库检索显示，在手术前接受 B 型 US 和 SWE 检查的患者中，有 120 例经活检证实为 DCIS。记录临床病理结果、B 型 US 表现、US 上的大小以及 SWE 上的平均和最大弹性值。使用单变量、多变量逻辑回归和多元线性回归分析评估升级为浸润性癌与 B 型 US 发现、SWE 信息和临床变量之间的关联。
总体升级率为 41.7%（50/120）。平均刚性值（P=.014）和质量大小（P=.001）与组织学升级显著相关。平均刚性值的最佳截断值，产生最大的敏感性和特异性总和，为 70.7 kPa，其对检测侵袭性的敏感性为 72%，特异性为 65.7%。定性弹性彩色评分与组织学升级、乳腺密度和 B 型类别显著相关（P<.04）。
通过 SWE 评估的平均刚性值可作为经 US 引导的针活检证实的 DCIS 组织学升级为浸润性癌的术前预测指标。
浸润性癌的刚性值高于 DCIS。
SWE 定性彩色评分与组织学升级显著相关。
SWE 定性彩色评分具有良好的观察者间一致性。
