Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography

The aim of this study was to evaluate the diagnostic performance of shear wave elastography by acoustic radiation force impulse (ARFI) elastography in differentiating malignant and benign breast Lesions in comparison with strain elastography and B mode ultrasound. This was prospective study, we used the commercially available eSie touch elastography imaging. In the shear wave elastography (SWE) we had two modes, the virtual touch imaging (VTI) with interpretation with the 5 points elasticity score and virtual touch quantification (VTQ) technique with the calculation of the Shear wave velocity (SWV). The study included 142 solid breast masses, of them 75 (52.8%) were benign and 67 (47.2%) were malignant. The mean shear wave velocity differed significantly between the benign and malignant groups (2.4+1.3m/sec and 7.3+2.2m/sec respectively, P value <0.0001). the sensitivity, specificity, PPV, NPV and accuracy of strain (eSie touch) elastography score was 83.1%, 88.73%, 88.06%, 84% and 85.92% respectively, which was less than the elastography score by ARFI (92.42%, 92.11%, 91.04%, 93.33% and 92.25% respectively) and less than the VTQ (SWV) which was 94.03%, 95.95%, 95.45% and 95.04% respectively. We concluded that Both the SWE and SE elastography showed significant difference between the benign and malignant masses, and both has added value above B mode ultrasound during routine examination. Shear wave elastography had higher sensitivity and specificity than SE, and less false negative and false positive results. The quantitative SWE (SWV) had the highest diagnostic performance among the different studied techniques.