Diagnostic performance of solid breast lesions shearwave elastography with histopathological correlation

Introduction: Shearwave elastography (SWE) is an emerging technique of obtaining quantitative tissue elasticity data during breast ultrasound examinations. Objectives: The aim of this study were (1) to determine the mean of maximum SWE value of malignant and benign breast lesions (2) to determine t...

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Main Author:	Omar, Siti Hajar
Format:	Thesis
Language:	English
Published:	2016
Subjects:	RG Gynecology and obstetrics
Online Access:	http://eprints.usm.my/44115/1/Dr.%20Siti%20Hajar%20Omar-24%20pages.pdf
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spelling	my-usm-ep.441152020-10-22T03:03:19Z Diagnostic performance of solid breast lesions shearwave elastography with histopathological correlation 2016 Omar, Siti Hajar RG Gynecology and obstetrics Introduction: Shearwave elastography (SWE) is an emerging technique of obtaining quantitative tissue elasticity data during breast ultrasound examinations. Objectives: The aim of this study were (1) to determine the mean of maximum SWE value of malignant and benign breast lesions (2) to determine the sensitivity and specificity of SWE correlating with histopathology (3) to determine the agreement between SWE and greyscale ultrasound in differentiating malignant and benign breast lesions. Methodology: Using the Aixplorer® ultrasound system 174 solid breast lesions were identified using us. For each lesion, quantitative elasticity was measured and BI-RADS categories assessed with greyscale. SWE maximum value was calculated and compared with the previously published cut-off value (COV). SWE measurements were correlated with histology results. Greyscale images according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) categories 1-3 were taken as benign while categories 4-6 were classified as malignant. Results: Of the 174 breast lesions, 149 (85.6 %) were benign and 25 (14.4%) were malignant revealed by histology. The mean of maximum elasticity values were significantly higher in malignant lesions (98.00 kPa ± 50.39) than benign lesions (28.16 kPa ± 17.22), (P ˂ 0 .001). The optimal SWE cut-off value was 42.58 kPa with sensitivity and specificity of SWE were 84.0% and 81.0%, positive predictive value (PPV) and negative predictive value (NPV) were 42.0% and 97.0% respectively. The AUC of ROC curve was 0.864 for greyscale ultrasound, 0.824 for SWE, and 0.773 for combined greyscale and SWE. There was moderate agreement between results from BI-RADS with COV of 3.5 and SWE of the three COVs. The Kappa agreement between BI-RADS and SWE was increased from 0.458 to 0.550, as the SWE COV increased from 42.58 kPa to 50.0 kPa and 80.0 kPa. Overall, the highest agreement was obtained between BIRADS (COV=3.5) and SWE (COV=80 kPa). Conclusions: Malignant breast lesions have higher maximum SWE value compared to benign lesions . The overall diagnostic performance of combination grey scale ultrasound and SWE was not significantly better than that of ultrasound alone. The optimum COV of SWE obtained from this study was lower than the previous studies, however one might choose higher COV in order to increase the specificity of this potential adjunct screening and diagnostic tool particularly in BI-RADS III or IV breast lesion. 2016 Thesis http://eprints.usm.my/44115/ http://eprints.usm.my/44115/1/Dr.%20Siti%20Hajar%20Omar-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RG Gynecology and obstetrics
spellingShingle	RG Gynecology and obstetrics Omar, Siti Hajar Diagnostic performance of solid breast lesions shearwave elastography with histopathological correlation
description	Introduction: Shearwave elastography (SWE) is an emerging technique of obtaining quantitative tissue elasticity data during breast ultrasound examinations. Objectives: The aim of this study were (1) to determine the mean of maximum SWE value of malignant and benign breast lesions (2) to determine the sensitivity and specificity of SWE correlating with histopathology (3) to determine the agreement between SWE and greyscale ultrasound in differentiating malignant and benign breast lesions. Methodology: Using the Aixplorer® ultrasound system 174 solid breast lesions were identified using us. For each lesion, quantitative elasticity was measured and BI-RADS categories assessed with greyscale. SWE maximum value was calculated and compared with the previously published cut-off value (COV). SWE measurements were correlated with histology results. Greyscale images according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) categories 1-3 were taken as benign while categories 4-6 were classified as malignant. Results: Of the 174 breast lesions, 149 (85.6 %) were benign and 25 (14.4%) were malignant revealed by histology. The mean of maximum elasticity values were significantly higher in malignant lesions (98.00 kPa ± 50.39) than benign lesions (28.16 kPa ± 17.22), (P ˂ 0 .001). The optimal SWE cut-off value was 42.58 kPa with sensitivity and specificity of SWE were 84.0% and 81.0%, positive predictive value (PPV) and negative predictive value (NPV) were 42.0% and 97.0% respectively. The AUC of ROC curve was 0.864 for greyscale ultrasound, 0.824 for SWE, and 0.773 for combined greyscale and SWE. There was moderate agreement between results from BI-RADS with COV of 3.5 and SWE of the three COVs. The Kappa agreement between BI-RADS and SWE was increased from 0.458 to 0.550, as the SWE COV increased from 42.58 kPa to 50.0 kPa and 80.0 kPa. Overall, the highest agreement was obtained between BIRADS (COV=3.5) and SWE (COV=80 kPa). Conclusions: Malignant breast lesions have higher maximum SWE value compared to benign lesions . The overall diagnostic performance of combination grey scale ultrasound and SWE was not significantly better than that of ultrasound alone. The optimum COV of SWE obtained from this study was lower than the previous studies, however one might choose higher COV in order to increase the specificity of this potential adjunct screening and diagnostic tool particularly in BI-RADS III or IV breast lesion.
format	Thesis
qualification_level	Master's degree
author	Omar, Siti Hajar
author_facet	Omar, Siti Hajar
author_sort	Omar, Siti Hajar
title	Diagnostic performance of solid breast lesions shearwave elastography with histopathological correlation
title_short	Diagnostic performance of solid breast lesions shearwave elastography with histopathological correlation
title_full	Diagnostic performance of solid breast lesions shearwave elastography with histopathological correlation
title_fullStr	Diagnostic performance of solid breast lesions shearwave elastography with histopathological correlation
title_full_unstemmed	Diagnostic performance of solid breast lesions shearwave elastography with histopathological correlation
title_sort	diagnostic performance of solid breast lesions shearwave elastography with histopathological correlation
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2016
url	http://eprints.usm.my/44115/1/Dr.%20Siti%20Hajar%20Omar-24%20pages.pdf
_version_	1747821330409979904

Diagnostic performance of solid breast lesions shearwave elastography with histopathological correlation

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