Combined use of shear-wave elastography and Doppler ultrasonography in equivocal fibroepithelial lesions of the breast diagnosed by core needle biopsy
Purpose The aim of this study was to evaluate the diagnostic value of shear-wave elastography (SWE) combined with Doppler ultrasonography (US) in selecting equivocal breast fibroepithelial lesions (FELs) for follow-up without further excision. Methods A retrospective analysis was conducted of 88 pat...
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| Format: | Article |
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Korean Society of Ultrasound in Medicine
2023-01-01
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| Series: | Ultrasonography |
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| Online Access: | http://www.e-ultrasonography.org/upload/usg-22008.pdf |
| _version_ | 1828070621144154112 |
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| author | Ji Soo Choi Eun Young Ko Min-Ji Kim Eun Sook Ko Boo-Kyung Han |
| author_facet | Ji Soo Choi Eun Young Ko Min-Ji Kim Eun Sook Ko Boo-Kyung Han |
| author_sort | Ji Soo Choi |
| collection | DOAJ |
| description | Purpose The aim of this study was to evaluate the diagnostic value of shear-wave elastography (SWE) combined with Doppler ultrasonography (US) in selecting equivocal breast fibroepithelial lesions (FELs) for follow-up without further excision. Methods A retrospective analysis was conducted of 88 patients with equivocal breast FELs (FELs with the possibility of both fibroadenoma [FA] and phyllodes tumor [PT]) diagnosed by core needle biopsy (CNB). For post-CNB treatment, surgical or vacuum-assisted excision was performed on 88 equivocal FELs, of which 56 were diagnosed as FAs and 32 as PTs on histopathology. Mean elasticity (Emean) and vascularity were determined using SWE and Doppler US. The diagnostic performances of B-mode US, SWE, and Doppler US were calculated to differentiate FAs and PTs in the excised equivocal FELs. Results In the excised equivocal FELs diagnosed by CNB, FAs showed significantly lower median Emean values (36.4 vs. 66.7 kPa, P=0.005) and more frequent low vascularity (0–1 vessel flow signal) (P<0.001) than PTs. For the differentiation of FAs and PTs, the combination of Emean of >60.9 kPa and high vascularity (≥2 vessel flows) showed a sensitivity and negative predictive value of 100%, as well as better performance in other diagnostic values than B-mode US alone (Breast Imaging Reporting and Data System ≥4A) (all P<0.05). Conclusion Equivocal breast FELs showing both low elasticity and low vascularity were not upgraded to PTs upon further excision. Therefore, the combination of SWE and color Doppler US mode might help select patients with equivocal FELs for whom further excision is unnecessary. |
| first_indexed | 2024-04-11T00:40:43Z |
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| id | doaj.art-c9253b01411444f295337b216610fb9b |
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| issn | 2288-5919 2288-5943 |
| language | English |
| last_indexed | 2024-04-11T00:40:43Z |
| publishDate | 2023-01-01 |
| publisher | Korean Society of Ultrasound in Medicine |
| record_format | Article |
| series | Ultrasonography |
| spelling | doaj.art-c9253b01411444f295337b216610fb9b2023-01-06T07:21:45ZengKorean Society of Ultrasound in MedicineUltrasonography2288-59192288-59432023-01-01421314010.14366/usg.220081622Combined use of shear-wave elastography and Doppler ultrasonography in equivocal fibroepithelial lesions of the breast diagnosed by core needle biopsyJi Soo Choi0Eun Young Ko1Min-Ji Kim2Eun Sook Ko3Boo-Kyung Han4 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaPurpose The aim of this study was to evaluate the diagnostic value of shear-wave elastography (SWE) combined with Doppler ultrasonography (US) in selecting equivocal breast fibroepithelial lesions (FELs) for follow-up without further excision. Methods A retrospective analysis was conducted of 88 patients with equivocal breast FELs (FELs with the possibility of both fibroadenoma [FA] and phyllodes tumor [PT]) diagnosed by core needle biopsy (CNB). For post-CNB treatment, surgical or vacuum-assisted excision was performed on 88 equivocal FELs, of which 56 were diagnosed as FAs and 32 as PTs on histopathology. Mean elasticity (Emean) and vascularity were determined using SWE and Doppler US. The diagnostic performances of B-mode US, SWE, and Doppler US were calculated to differentiate FAs and PTs in the excised equivocal FELs. Results In the excised equivocal FELs diagnosed by CNB, FAs showed significantly lower median Emean values (36.4 vs. 66.7 kPa, P=0.005) and more frequent low vascularity (0–1 vessel flow signal) (P<0.001) than PTs. For the differentiation of FAs and PTs, the combination of Emean of >60.9 kPa and high vascularity (≥2 vessel flows) showed a sensitivity and negative predictive value of 100%, as well as better performance in other diagnostic values than B-mode US alone (Breast Imaging Reporting and Data System ≥4A) (all P<0.05). Conclusion Equivocal breast FELs showing both low elasticity and low vascularity were not upgraded to PTs upon further excision. Therefore, the combination of SWE and color Doppler US mode might help select patients with equivocal FELs for whom further excision is unnecessary.http://www.e-ultrasonography.org/upload/usg-22008.pdfphyllodes tumorfibroadenomaultrasounddiagnosisbreastshear-wave elastographydoppler ultrasonography |
| spellingShingle | Ji Soo Choi Eun Young Ko Min-Ji Kim Eun Sook Ko Boo-Kyung Han Combined use of shear-wave elastography and Doppler ultrasonography in equivocal fibroepithelial lesions of the breast diagnosed by core needle biopsy Ultrasonography phyllodes tumor fibroadenoma ultrasound diagnosis breast shear-wave elastography doppler ultrasonography |
| title | Combined use of shear-wave elastography and Doppler ultrasonography in equivocal fibroepithelial lesions of the breast diagnosed by core needle biopsy |
| title_full | Combined use of shear-wave elastography and Doppler ultrasonography in equivocal fibroepithelial lesions of the breast diagnosed by core needle biopsy |
| title_fullStr | Combined use of shear-wave elastography and Doppler ultrasonography in equivocal fibroepithelial lesions of the breast diagnosed by core needle biopsy |
| title_full_unstemmed | Combined use of shear-wave elastography and Doppler ultrasonography in equivocal fibroepithelial lesions of the breast diagnosed by core needle biopsy |
| title_short | Combined use of shear-wave elastography and Doppler ultrasonography in equivocal fibroepithelial lesions of the breast diagnosed by core needle biopsy |
| title_sort | combined use of shear wave elastography and doppler ultrasonography in equivocal fibroepithelial lesions of the breast diagnosed by core needle biopsy |
| topic | phyllodes tumor fibroadenoma ultrasound diagnosis breast shear-wave elastography doppler ultrasonography |
| url | http://www.e-ultrasonography.org/upload/usg-22008.pdf |
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