Marukatat N, Parklug P, Issaragrisil S, Sumanasrethakul C
Department of Radiology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd., Dusit, Bangkok 10300, Thailand.
Department of Urban Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd., Bangkok 10300, Thailand.
Eur J Radiol Open. 2024 May 29;12:100573. doi: 10.1016/j.ejro.2024.100573. eCollection 2024 Jun.
Shear wave elastography (SWE), an ultrasonographic technique to measure the elasticity of mass lesions to evaluate breast mass. This study aimed to find out the cutoff values identifying breast malignancy using the mean elasticity (E-mean) and elasticity ratio (E-ratio) of breast masses.
This retrospective study included women underwent SWE and US-guided biopsy of breast masses. During conventional US, the SWE mode was also performed, determining elasticity measurements, E-mean and E-ratio. Histopathological reports were obtained to identify mass status. The optimal and alternative cutoff values for E-mean and E-ratio to determine malignancy were assessed by receiver operating characteristic (ROC) curve analysis and Youden's index score.
Among 147 benign and 93 malignant masses, the median of E-means were 26.20 (IQR 15.70-56.60) and 141.60 (IQR 119.80-154.60) kPa and the median E-ratios were 3.11 (IQR 1.83-5.23) and 9.24 (IQR 6.76-12.44), respectively. Using Youden's index, the optimal cutoff values for E-mean and E-ratio were 90.35 and 5.89, with sensitivity of 87.1 % and 82.8 %, specificity of 89.1 % and 83.7 %, positive predictive value (PPV) of 83.5 % and 76.2 %, negative predictive value (NPV) of 91.6 % and 88.5 %, positive likelihood ratio (LR+) of 8.00 and 5.07, and negative likelihood ratio (LR-) of 0.14 and 0.21, respectively.
This study revealed that SWE is useful in predicting malignancy. With the optimal cutoff values of E-mean and E-ratio at 90.35 kPa and 5.89, the sensitivity was nearly 90 % with E-mean and slightly over 80 % with E-ratio, respectively. These findings could be used in conjunction with conventional US.
剪切波弹性成像（SWE）是一种超声技术，用于测量乳腺肿块的弹性以评估乳腺肿块。本研究旨在找出利用乳腺肿块的平均弹性（E-mean）和弹性比（E-ratio）来识别乳腺恶性肿瘤的临界值。
这项回顾性研究纳入了接受乳腺肿块SWE和超声引导下活检的女性。在常规超声检查期间，也进行SWE模式，测定弹性测量值、E-mean和E-ratio。获取组织病理学报告以确定肿块状态。通过受试者操作特征（ROC）曲线分析和尤登指数评分评估E-mean和E-ratio用于确定恶性肿瘤的最佳和替代临界值。
在147个良性肿块和93个恶性肿块中，E-mean的中位数分别为26.20（四分位间距15.70 - 56.60）和141.60（四分位间距119.80 - 154.60）kPa，E-ratio的中位数分别为3.11（四分位间距1.83 - 5.23）和9.24（四分位间距6.76 - 12.44）。使用尤登指数，E-mean和E-ratio的最佳临界值分别为90.35和5.89，敏感性分别为87.1%和82.8%，特异性分别为89.1%和83.7%，阳性预测值（PPV）分别为83.5%和76.2%，阴性预测值（NPV）分别为91.6%和88.5%，阳性似然比（LR+）分别为8.00和5.07，阴性似然比（LR-）分别为0.14和0.21。
本研究表明SWE在预测恶性肿瘤方面有用。E-mean和E-ratio的最佳临界值分别为90.35 kPa和5.89，E-mean的敏感性接近90%，E-ratio的敏感性略高于80%。这些发现可与常规超声联合使用。
