Supersonic shear waves quantitative elastography and kinetic magnetic resonance dynamic curve in discriminating BI-RADS 4 breast masses: A comparative study

Abstract

Purpose: The purpose of this study was to evaluate the usefulness of shear wave elastography (SWE) versus MRI dynamic curve in discriminating BI-RADS 4 breast masses to detect which modality is more sensitive and specific. Patients and methods: Sixty-three patients presented by breast masses and categorized as BI-RADS 4 by mammography and ultrasound over the study period for 1 year were included. We analyzed and compared the quantitative dynamic MRI curve types with E-maximum (E-Max) shear wave (SW) velocity values. Results: Histopathological evaluation revealed 41.3% of the cases had benign lesions and 58.7% had a malignant lesion. The mean E-max SW value of each pathology and its corresponding dynamic MRI curve were analyzed. At a cutoff value 45.3 kPa ± 41.1 for benign lesions and 146.6 kPa ± 40.05 for malignant lesions, the recorded sensitivity, specificity and accuracy of quantitative SWE in differentiating between the benign and malignant BI-RADS 4 breast lesions were 89.5%, 88%, and 88.9%, respectively and those for DC-MRI curve were 100%, 92.3%, and 96.8%, respectively. Conclusion: Quantitative measurements are more vulnerable in detecting and differentiating BI-RADS 4 lesions. Type of the dynamic MRI curve is more sensitive, specific and accurate than SWE.

Keywords

• Shear wave elastography
• Contrast enhanced MRI
• BI-RADS4 breast lesions