Diagnostic Value Of Shear Wave Elastography Combined With Diffuse Optical Tomography In Benign And Malignant Breast Nodules

Objective To explore the diagnostic efficiency of various parameters of shear wave elastography(SWE),and to analyze the diagnostic value of SWE and diffuse optical tomography(DOT)alone and in combination for benign and malignant breast nodules.Methods From November 2018 to December 2019,91 female patients with breast nodules were selected from our hospital.There were 96 lesions in total.The maximum diameter of the tumor was 0.47-3.90(1.79±0.84)cm.The age range was 18-81(44.88±14.00)years.All selected lesions were obtained pathological results by biopsy or surgery.Each tumor had complete image data of DOT and SWE at the same time.SPSS19.0 software was used to analyze the data.The pathological results were taken as the gold standard.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the maximum elastic modulus(Emax),the average elastic modulus(Emean),the ratio of elastic modulus of lesions to surrounding tissues(Eratio),and the standard deviation(SD)were compared.The best parameters of diagnosis efficiency were selected for joint diagnosis with DOT.The diagnostic efficacy of SWE,DOT alone and combined diagnosis was analyzed.Results 1.There were 96 masses in 91 patients.The pathology was obtained by biopsy or operation,including 55 benign masses and 41 malignant masses.2.The area under the receiver operator characteristic(ROC)curve of Emax,Emean,Eratio and SD were 0.95(0.91-0.98),0.88(0.83-0.93),0.83(0.80-0.87),0.92(0.89-0.95),P < 0.001,so as to determine the cutoff values of each parameter: Emax 57.3kpa,Emean 29.5kpa,Eratio 6.2kpa,SD12.8kpa.By comparing the diagnostic value of each parameter,Emax has the best diagnostic efficiency(P < 0.05).3.The area of total hemoglobin(HBT)under the curve was 0.82(0.74-0.91),P < 0.001.The best cutoff value of HBT was 147 ?mol/L,which was used as the boundary value of DOT to distinguish the nature of breast masses.4.Combined application of SWE and DOT can accurately diagnose 37 malignant and 53 benign masses,with sensitivity of 90.24%,specificity of 96.36%,false positive rate of 3.64%,false negative rate of 9.76%,positive predictive value of 94.87%,negative predictive value of 92.98%,accuracy of 93.75%,and yoden index of 0.87.5.The specificity,positive predictive value and accuracy of the combined group were 96.36%,94.87% and 93.75%,respectively,with statistical significance(P < 0.05).The false positive rate of the combined group was 3.64%,which was statistically significant compared with SWE and DOT alone(P < 0.05);the combined sensitivity was90.24%,the negative predictive value was 92.98%,and the difference was not statistically significant.In conclusion,the combined group maintained a high level of sensitivity and negative predictive value while improving the specificity,positive predictive value and accuracy,and reducing the false-positive rate.It was confirmed that the combined application of SWE and DOT was more effective in detecting benign and malignant breast masses.Conclusions 1.Among the parameters of SWE,Emax has a high value in the diagnosis of benign and malignant breast nodules.When Emax = 57.3kpa as the cutoff value,it has the best diagnostic efficiency.2.DOT provides functional information for the differential diagnosis of breast benign and malignant nodules,which is helpful for the detection of early breast cancer.3.The combination of DOT and SWE in the differential diagnosis of breast benign and malignant nodules can not only improve the specificity,positive predictive value and accuracy,but also maintain a high level of sensitivity,so as to ensure that the nature of the mass can be effectively distinguished.