Evaluation of shear wave elastography for differential diagnosis of breast lesions: A new qualitative analysis versus conventional quantitative analysis

OBJECTIVE: To evaluate a special kind of ultrasound (US) shear wave elastography for differential diagnosis of breast lesions, using a newqualitative analysis (i.e. the elasticity score in the travel time map) compared with conventional quantitative analysis. METHODS: From June 2014 to July 2015, 266 pathologically proven breast lesions were enrolled in this study. The maximum, mean, median, minimum, and standard deviation of shear wave speed (SWS) values (m/s) were assessed. The elasticity score, a new qualitative feature, was evaluated in the travel time map. The area under the receiver operating characteristic (AUROC) curves were plotted to evaluate the diagnostic performance of both qualitative and quantitative analyses for differentiation of breast lesions. RESULTS: Among all quantitative parameters, SWS-max showed the highest AUROC (0.805; 95% CI: 0.752, 0.851) compared with SWS-mean (0.786; 95% CI: 0.732, 0.834; P = 0.094), SWS-median (0.775; 95% CI: 0.720, 0.824; P = 0.046), SWS-min (0.675; 95% CI: 0.615, 0.731; P = 0.000), and SWS-SD (0.768; 95% CI: 0.712, 0.817; P = 0.074). The AUROC of qualitative analysis in this study obtained the best diagnostic performance (0.871; 95% CI: 0.825, 0.909, compared with the best parameter of SWS-max in quantitative analysis, P = 0.011). CONCLUSIONS: The new qualitative analysis of shear wave travel time showed the superior diagnostic performance in the differentiation of breast lesions in comparison with conventional quantitative analysis.