Imaging Characterization of Local Breast Lesions Using Shear Wave Sono elastography

Shadan Jasim  Mohammed; Saeed Nadhim  Younis Agha

doi:10.56056/amj.2025.313

Authors

Shadan Jasim Mohammed M.B.Ch.B., Rizgary Teaching Hospital, Radiology Department
Saeed Nadhim Younis Agha M.B.Ch.B, DMRD, Ph.D., Professor of Radiology, Kurdistan Board of Medical Specialties

DOI:

https://doi.org/10.56056/amj.2025.313

Keywords:

BI-RADS, Breast mass, Shear wave elastography, Ultrasonography

Abstract

Background & objective: Advancements in breast tumor screening and diagnosis are crucial for improving treatment outcomes and reducing mortality rates. This study evaluated the diagnostic accuracy of integrating quantitative shear wave elastography with B-mode ultrasonography to differentiate benign from malignant breast lesions, keeping histopathology as reference standard.

Methods: This cross-sectional observational study implemented in Breast center in Erbil, Kurdistan, from May to September 2022. The women with breast mass were examined clinically by breast surgeon at the center and then referred to Radiology department for imaging. Both B-mode Ultrasound and Shear Wave Elastography were performed on 45 US-detected breast masses prior to any biopsy procedures. For each detected lesion, two key parameters were assessed: The Breast Imaging Reporting and Data System category based on B-mode ultrasound images and the mean elasticity values obtained from Shear Wave Sono elastography images. This dual approach aimed to provide a comprehensive evaluation of each lesion. Following the imaging, histopathological diagnoses were obtained for all lesions, taken as the gold standard.

Results: Histopathological examination, carried out by a specialized radiologist using core biopsy and Fine Needle Aspiration Cytology and analyzed by a pathologist with a consistent assessment protocol, revealed 55.6%benign and 44.4% malignant. B-mode ultrasound using the BI-RADS system, categorized 71.1% as BI-RADS 4, 15.6% as BI-RADS 5, and 13.3% as BI-RADS 3. Shear Wave Sono elastography proved critical, revealing significantly higher mean elasticity malignant cases (p<0.001. A strong correlation was found between increased elasticity and malignancy, as well as between elasticity and BI-RADS categorization (p=0.004). Malignant tumors had a direct link to elasticity (p=0.02). The optimal cutoff mean shear wave elasticity was 80 kPa with 90%sensitivity, 80% specificity and 84.4%accuracy.

Conclusions: Quantitative shear wave Sono elastography, combined with B-mode ultrasonography effectively categorize breast lesions, correlating strongly with histopathological findings. It emerges as a vital, non-invasive diagnostic tool, enhancing the accuracy of breast lesions characterization.

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