Additional diagnostic value of shear-wave elastography and color Doppler US for evaluation of breast non-mass lesions detected at B-mode US

AbstractObjectiveTo evaluate the diagnostic value of shear-wave elastography (SWE) and colour Doppler ultrasound (US) for evaluation of breast non-mass lesions (NMLs) detected by B-mode US.MethodsThis retrospective study enrolled 116 NMLs (42 benign, 74 malignant). For each lesion, B-mode US, SWE and colour Doppler US were performed. Mean elasticity (Emean), maximum elasticity (Emax) and vascularity were assessed by SWE and Doppler US. Diagnostic performances of B-mode US, SWE and Doppler US were calculated to differentiate benign and malignant NMLs.ResultsIn benign NMLs, average Emean and Emax were lower, and low vascularity (no flow or only one vessel flow) was more frequent (P < 0.001). When BI-RADS category 4a NMLs were downgraded to category 3 with ‘Emean of 85.1 kPa or less’ and/or ‘low vascularity’, specificities increased (69.0–90.5 %; P < 0.001), without significant loss in sensitivities (97.3–100 %). When these 4a NMLs were downgraded by the combination of SWE and Doppler US, all downgraded NMLs (59.3 %, 19/32) were confirmed as benign.ConclusionsAddition of SWE and colour Doppler US to B-mode US improved diagnostic performances in differentiating benign and malignant NMLs. This study suggests that the combination of SWE and colour Doppler may help patients with BI-RADS category 4a NMLs avoid unnecessary biopsies.Key Points• B-mode US features of malignant and benign NMLs may overlap. • SWE and colour Doppler provides useful information about breast NMLs. • SWE and colour Doppler may decrease unnecessary biopsies of breast NMLs.