The Values of Elastic Quantitative and Semi-quantitative Indexes Measured from Different Frequencies in the Establishment of Prediction Models for Breast Tumor Diagnosis

Overview

Journal BMC Med Imaging

Publisher Biomed Central

Specialty Radiology

Date 2022 Nov 15

PMID 36380288

Authors

Xiao Xie

Yibo Ma

Xiaoxiao Xing

Haixia Zhou

Shuiqing Liu

Yanyan Zhang

Min Xu

Affiliations

Soon will be listed here.

Abstract

Objective: To obtain the elastic quantitative and semi-quantitative indexes of solid breast masses using ultrasound linear array probes with two different frequencies, and to construct prediction models and evaluate their diagnostic values.

Methods: A total of 92 patients who were scheduled for surgical treatment on solid breast masses were enrolled in this study. Linear array probes with two frequencies, 9-3 MHz (L9 group) and 14-5 MHz (L14 group), were used for sound touch elastography and strain elastography before surgery, and the maximum elasticity value (Emax), average elasticity value (Emean), minimum elasticity value (Emin), standard deviation (SD)(in kPa), elasticity ratio (E), and strain ratio to fat (SRf) were recorded and calculated for the breast mass (A) and surrounding tissues (Shell). The elastic characteristic indexes of the L9 group and L14 group were compared, and the prediction models of these two groups were constructed using Logistic regression method.

Results: The diagnostic performance of the prediction model based on L9 group was better than the model based on L14 group (AUC: 0.904 vs. 0.810, P = 0.0343, z = 2.116) and the best single index EMax-shell-L9 (P = 0.0398, z = 2.056). The sensitivity of L9 based model was 85.19% and the specificity was 84.21%.

Conclusion: The prediction model based on quantitative and semi-quantitative elastic ultrasound indexes from L9-3 probe exhibited better performance, which could improve the diagnostic accuracy for malignant breast tumors.

Citing Articles

Diagnostic efficacy of ultrasound elastography and dynamic contrast-enhanced MR in benign and malignant breast masses.

Tao Z, Qi H, Ma Y Am J Transl Res. 2023; 15(4):2870-2877.

PMID: 37193163 PMC: 10182532.

References

Zhou J, Zhan W, Dong Y, Yang Z, Zhou C . Stiffness of the surrounding tissue of breast lesions evaluated by ultrasound elastography. Eur Radiol. 2014; 24(7):1659-67. DOI: 10.1007/s00330-014-3152-7. View

Xie X, Zhang Q, Liu S, Ma Y, Liu Y, Xu M . Value of quantitative sound touch elastography of tissues around breast lesions in the evaluation of malignancy. Clin Radiol. 2020; 76(1):79.e21-79.e28. DOI: 10.1016/j.crad.2020.08.016. View

Choi H, Seo M, Sohn Y, Hwang J, Song E, Min S . Shear wave elastography for the diagnosis of small (≤2 cm) breast lesions: added value and factors associated with false results. Br J Radiol. 2019; 92(1097):20180341. PMC: 6580903. DOI: 10.1259/bjr.20180341. View

Park H, Lim Y, Ko E, Cho H, Lee J, Han B . Radiomics Signature on Magnetic Resonance Imaging: Association with Disease-Free Survival in Patients with Invasive Breast Cancer. Clin Cancer Res. 2018; 24(19):4705-4714. DOI: 10.1158/1078-0432.CCR-17-3783. View

Syversveen T, Midtvedt K, Berstad A, Brabrand K, Strom E, Abildgaard A . Tissue elasticity estimated by acoustic radiation force impulse quantification depends on the applied transducer force: an experimental study in kidney transplant patients. Eur Radiol. 2012; 22(10):2130-7. DOI: 10.1007/s00330-012-2476-4. View

Yang L, Yuan J, Wang Q, Wu G, Guo W, Wang W . Reliability analysis of acoustic radiation force impulse ultrasound imaging with virtual touch tissue quantification: ex vivo ox liver. Ultrasound Q. 2015; 31(1):59-62. DOI: 10.1097/RUQ.0000000000000070. View

Barr R . Shear wave imaging of the breast: still on the learning curve. J Ultrasound Med. 2012; 31(3):347-50. DOI: 10.7863/jum.2012.31.3.347. View

DeLong E, Delong D, Clarke-Pearson D . Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988; 44(3):837-45. View

Wang J, Guo Z, Lin Q, Zheng W, Zhuang S, Lin S . Ultrasound elastography as an imaging biomarker for detection of early tumor response to chemotherapy in a murine breast cancer model: a feasibility study. Br J Radiol. 2018; 91(1085):20170698. PMC: 6190766. DOI: 10.1259/bjr.20170698. View

10.

Song E, Sohn Y, Seo M . Tumor stiffness measured by quantitative and qualitative shear wave elastography of breast cancer. Br J Radiol. 2018; 91(1086):20170830. PMC: 6223289. DOI: 10.1259/bjr.20170830. View

11.

Li D, Xu H, Guo L, Bo X, Li X, Wu R . Combination of two-dimensional shear wave elastography with ultrasound breast imaging reporting and data system in the diagnosis of breast lesions: a new method to increase the diagnostic performance. Eur Radiol. 2015; 26(9):3290-300. DOI: 10.1007/s00330-015-4163-8. View

12.

Chang S, Kim M, Kim J, Lee M . Variability of shear wave velocity using different frequencies in acoustic radiation force impulse (ARFI) elastography: a phantom and normal liver study. Ultraschall Med. 2012; 34(3):260-5. DOI: 10.1055/s-0032-1313008. View

13.

Chee C, Lombardo P, Schneider M, Danovani R . Comparison of the Fat-to-Lesion Strain Ratio and the Gland-to-Lesion Strain Ratio With Controlled Precompression in Characterizing Indeterminate and Suspicious Breast Lesions on Ultrasound Imaging. J Ultrasound Med. 2019; 38(12):3257-3266. DOI: 10.1002/jum.15037. View

14.

Darweesh S, Yosry A, Salah M, Zayed N, Khairy A, Awad A . Acoustic radiation forced impulse-based splenic prediction model using data mining for the noninvasive prediction of esophageal varices in hepatitis C virus advanced fibrosis. Eur J Gastroenterol Hepatol. 2019; 31(12):1533-1539. DOI: 10.1097/MEG.0000000000001458. View

15.

Tozaki M, Fukuma E . Pattern classification of ShearWave™ Elastography images for differential diagnosis between benign and malignant solid breast masses. Acta Radiol. 2011; 52(10):1069-75. DOI: 10.1258/ar.2011.110276. View

16.

Suvannarerg V, Chitchumnong P, Apiwat W, Lertdamrongdej L, Tretipwanit N, Pisarnturakit P . Diagnostic performance of qualitative and quantitative shear wave elastography in differentiating malignant from benign breast masses, and association with the histological prognostic factors. Quant Imaging Med Surg. 2019; 9(3):386-398. PMC: 6462575. DOI: 10.21037/qims.2019.03.04. View

17.

Yoon J, Jung H, Lee J, Ko K . Shear-wave elastography in the diagnosis of solid breast masses: what leads to false-negative or false-positive results?. Eur Radiol. 2013; 23(9):2432-40. DOI: 10.1007/s00330-013-2854-6. View

18.

Son M, Kim S, Jung H, Ko K, Koh J, Park A . Can Ultrasonographic Vascular and Elastographic Features of Invasive Ductal Breast Carcinoma Predict Histologic Aggressiveness?. Acad Radiol. 2019; 27(4):487-496. DOI: 10.1016/j.acra.2019.06.009. View

19.

Zhou J, Zhou C, Zhan W, Jia X, Dong Y, Yang Z . Elastography ultrasound for breast lesions: fat-to-lesion strain ratio vs gland-to-lesion strain ratio. Eur Radiol. 2014; 24(12):3171-7. DOI: 10.1007/s00330-014-3366-8. View