Breast Lesions: Quantitative Elastography with Supersonic Shear Imaging—Preliminary Results

TLDR

The study aimed to characterize breast lesions using supersonic shear imaging elastography and to evaluate the relationship between quantitative stiffness values and histopathology. Forty‑six women with 48 breast lesions underwent conventional ultrasound and SSI elastography, with lesion stiffness quantified as Young’s modulus in kilopascals, and all lesions were detected by SSI. Malignant lesions had a mean elasticity of 146.6 kPa versus 45.3 kPa for benign lesions (P < 0.001), cysts showed 0 kPa, and receiver‑operator‑characteristic analysis yielded high sensitivity, specificity, and AUC, indicating SSI’s potential to aid lesion characterization.

Abstract

To determine the appearance of breast lesions at quantitative ultrasonographic (US) elastography by using supersonic shear imaging (SSI) and to assess the correlation between quantitative values of lesion stiffness and pathologic results, which were used as the reference standard.This study was approved by the French National Committee for the Protection of Patients Participating in Biomedical Research Programs. All patients provided written informed consent. Conventional US and SSI quantitative elastography were performed in 46 women (mean age, 57.6 years; age range, 38-71 years) with 48 breast lesions (28 benign, 20 malignant; mean size, 14.7 mm); pathologic results were available in all cases. Quantitative lesion elasticity was measured in terms of the Young modulus (in kilopascals). Sensitivity, specificity, and area under the curve were obtained by using a receiver operating characteristic curve analysis to assess diagnostic performance.All breast lesions were detected at SSI. Malignant lesions exhibited a mean elasticity value of 146.6 kPa +/- 40.05 (standard deviation), whereas benign ones had an elasticity value of 45.3 kPa +/- 41.1 (P < .001). Complicated cysts were differentiated from solid lesions because they had elasticity values of 0 kPa (no signal was retrieved from liquid areas).SSI provides quantitative elasticity measurements, thus adding complementary information that potentially could help in breast lesion characterization with B-mode US.