The Value Of Qualitative Shear Wave Elastography In Differential Diagnosis Of Benign And Malignant Breast Papillary Lesions

Objective:To assess the efficacy of the qualitative shear wave elastography(SWE)pattern classification in the differential diagnosis between malignant and benign breast papillary lesions.Methods:One hundred sixty-eight patients with 170 papillary lesions(134 benign and 36 malignant)that were surgically excised after grayscale ultrasound(US)and SWE examination were enrolled.Each mass was qualitatively classified by a new method.US BI-RADS and quantitative and qualitative SWE parameters were recorded.Diagnostic performances of two-dimensional US,SWE parameters and US combined to SWE parameters were compared using the area under the receiver operating characteristic curve(Az).Results:1.The highest Az value for US was 0.755(95% confidence interval [CI],0.683,0.818).The sensitivity was 88.89%(32 of 36),and the specificity was 47.01%(63 of134).2.The Az value for qualitative SWE pattern category(0.764;95% CI: 0.693,0.825)was similar to grayscale US(P=0.85),with sensitivity of 58.33%(21/36)and specificity of 88.81%(119/134).3.By adding the qualitative SWE pattern category to grayscale US,the specificity was increased(from 47.01% to 79.85%),although the improved performance(Az,0.809;95%CI,0.741-0.865)without statistical significance(P=0.11).Conclusion : Qualitative shear wave elastography combined with BI-RADS classification can improve the specificity of two-dimensional ultrasound in the diagnosis of breast papillary lesions.