2021 Volume 48 Issue 5 Pages 263-269
Purpose: We evaluated the benign and malignant diagnosis of breast tumors by adding shear wave elastography (SWE) to BI-RADS ultrasound (US). Methods: The maximum tumor diameter and depth width ratio (D/W) were measured by B-mode and categorized according to BI-RADS US in 97 breast tumors (55 benign and 42 malignant). Shear wave speed, elastic modulus, and color pattern classification of modulus were evaluated by SWE to determine the difference between benign and malignant tumors and to evaluate the diagnostic rate of malignant tumors. Results and Discussion: Malignant tumors were significantly older and had higher values for maximum tumor diameter, D/W, shear wave speed, and elastic modulus. Color pattern classification of the modulus in malignant tumors was often pattern 3 and 4 (p＜0.0001). Corrected for confounding factors, shear wave speed ≥4.07 m/s (odds ratio 17.1), elastic modulus ≥53.7 kPa (odds ratio 17.1), and color pattern ≥3 (odds ratio 19.2) were useful. Furthermore, in the analysis of 76 patients classified as BI-RADS US categories 3 and 4, the highest negative predictive value (91.7%) was found for color pattern ≥3, and the highest positive predictive value (61.9%) was found for shear wave speed ≥4.07 m/s or elastic modulus ≥53.7 kPa, suggesting the usefulness of additional evaluation of SWE. Conclusion: Addition of SWE findings to BI-RADS US findings, especially in cases of categories 3 and 4, might improve the diagnostic rate.
