Comparison of the Diagnostic Performance of Shear Wave Elastography and Strain Elastography in Differentiating Benign and Malignant Breast Masses: A Prospective Study in Iran

Amirreza  Taherkhani; Kazem  Zendehdel; Masoumeh  Gity; Babak  Shekarchi; Ebadallah Shiri  Malekabad

doi:10.18502/jimc.v8i4.19555

Amirreza Taherkhani Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
Kazem Zendehdel Cancer Biology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
Masoumeh Gity Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Babak Shekarchi MAHAK Hematology Oncology Research Center (MAHAK-HORC), MAHAK Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Ebadallah Shiri Malekabad School of Nursing, AJA University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v8i4.19555

Keywords: Biopsy, Breast neoplasms, Elasticity, Elasticity imaging techniques, Female

Abstract

Background: Elastography is a non-invasive diagnostic imaging technique that assesses the elasticity or stiffness of tissues. This study aimed to compare the diagnostic performance of Shear Wave Elastography (SWE) and Strain Elastography (SE) in distinguishing benign from malignant breast masses.

Methods: In a prospective study, 447 women with breast masses were evaluated divided into two groups: 223 underwent SE, and 224 underwent SWE. Histopathological findings served as the gold standard. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and Receiver Operating Characteristic (ROC) curves were calculated for both techniques. Data analysis was performed using R software (version 4.3), with t-tests and chi-square tests for group comparisons.

Results: The mean age of participants was 46.1±9.8 years. Significant differences were observed between the benign and malignant groups in terms of age, mass size, and family history of breast cancer (p<0.05). For SWE, sensitivity, specificity, PPV, and NPV were 92, 93, 89, and 95%, respectively, compared to 85, 87, 82, and 89%, respectively for SE. The diagnostic accuracy of SWE was higher than SE (93 vs. 86%). The area under the ROC curve was 0.94 for SWE and 0.88 for SE.

Conclusion: SWE demonstrated superior diagnostic performance compared to SE in differentiating benign and malignant breast masses. This non-invasive technique can serve as a valuable clinical tool to improve diagnostic accuracy for malignancies and reduce unnecessary biopsies. However, multicenter studies with larger, more diverse samples are needed to validate these findings.