Shear wave versus strain elastography in the differentiation of benign and malignant breast lesions

Background/aim: To evaluate and compare the diagnostic performances of shear wave elastography (SWE) and strain elastography (SE) in the differentiation of benign and malignant breast lesions. Materials and methods: The current study included 87 breast lesions in 84 patients. The Breast Imaging Reporting and Data System (BIRADS) categories were determined with ultrasound features. The maximum shear wave velocity (SWV), mean SWV, maximum SWV to fat SWV ratio, and mean SWV to fat SWV ratio were measured using SWE. The strain ratio (SR) was calculated as the ratio of lesion strain to the adjacent fat strain using SE. Receiver operating characteristic (ROC) curves were constructed to assess and compare the diagnostic performances of each parameter. Results: Forty-five benign and 42 malignant lesions were diagnosed. The sensitivity and specificity of the BIRADS classification was 100% and 35.6%, respectively. Selecting a cutoff SR value of 3.22 led to an 88.1% sensitivity and an 88.4% specificity (AUC: 0.913 [95% CI: 0.854–0.971], P < 0.001). Selecting cutoff maximum SWV value of 3.41 m/s led to an 88.1% sensitivity and an 86.7% specificity (AUC: 0.918 [95% CI: 0.858–0.978], P< 0.001). The diagnostic performance of the maximum SWV, mean SWV, and maximum SWV to fat SWV ratio were similar to the diagnostic performance of the SR (P = 1.00, P= 1.00, P= 0.629, respectively). Conclusion: SE and SWE are both feasible imaging modalities in the differentiation of malignant and benign breast lesions with similar diagnostic performances.