University Breast Unit, Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany.
Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany.
J Ultrasound Med. 2024 Jan;43(1):109-114. doi: 10.1002/jum.16344. Epub 2023 Sep 29.
Shear wave elastography (SWE) is increasingly used in breast cancer diagnostics. However, large, prospective, multicenter data evaluating the reliability of SWE is missing. We evaluated the intra- and interobserver reliability of SWE in patients with breast lesions categorized as BIRADS 3 or 4.
We used data of 1288 women at 12 institutions in 7 countries with breast lesions categorized as BIRADS 3 to 4 who underwent conventional B-mode ultrasound and SWE. 1243 (96.5%) women had three repetitive conventional B-mode ultrasounds as well as SWE measurements performed by a board-certified senior physician. 375 of 1288 (29.1%) women received an additional ultrasound examination with B-mode and SWE by a second physician. Intraclass correlation coefficients (ICC) were calculated to examine intra- and interobserver reliability.
ICC for intraobserver reliability showed an excellent correlation with ICC >0.9, while interobserver reliability was moderate with ICC of 0.7. There were no clinically significant differences in intraobserver reliability when SWE was performed in lesions categorized as BI-RADS 3 or 4 as well as in histopathologically benign or malignant lesions.
Reliability of additional SWE was evaluated on a study cohort consisting of 1288 breast lesions categorized as BI-RADS 3 and 4. SWE shows an excellent intraobserver reliability and a moderate interobserver reliability in the evaluation of solid breast masses.
剪切波弹性成像（SWE）在乳腺癌诊断中的应用越来越广泛。然而，缺乏评估 SWE 可靠性的大型、前瞻性、多中心数据。我们评估了 SWE 在乳腺病变 BIRADS 3 或 4 患者中的观察者内和观察者间可靠性。
我们使用了来自 7 个国家 12 个机构的 1288 名乳腺病变 BIRADS 3 至 4 患者的数据，这些患者接受了常规 B 型超声和 SWE 检查。1243 名（96.5%）患者由一名具有董事会认证的高级医师进行了三次重复的常规 B 型超声和 SWE 测量。1288 名患者中的 375 名（29.1%）接受了由第二名医师进行的常规 B 型超声和 SWE 额外检查。计算了组内相关系数（ICC）来评估观察者内和观察者间的可靠性。
观察者内可靠性的 ICC 显示出极好的相关性，ICC>0.9，而观察者间可靠性为中等，ICC 为 0.7。在将 SWE 应用于 BIRADS 3 或 4 分类的病变以及组织病理学良性或恶性病变时，观察者内可靠性没有明显的差异。
在由 1288 个 BIRADS 3 和 4 分类的乳腺病变组成的研究队列中评估了额外的 SWE 的可靠性。在评估实性乳腺肿块时，SWE 显示出极好的观察者内可靠性和中等的观察者间可靠性。
