Design and Characterisation of a Polyvinyl Chloride (PVC) Tissue-Mimicking Polymer Phantom for Quantitative Shear Wave Elastography Validation.

A polyvinyl chloride (PVC)-based tissue-mimicking polymer phantom was developed and mechanically characterised to replicate stiffness ranges relevant to breast elastography and to provide a controlled platform for evaluating shear wave elastography (SWE) measurements. SWE provides quantitative stiffness information that complements B-mode ultrasound in breast imaging. However, measurement variability related to operator technique and tissue continues to limit confidence in clinical interpretation. This study evaluates the reproducibility of SWE using custom-fabricated PVC-based breast phantoms with mechanically defined stiffness properties. Two PVC-based breast phantoms with identical geometry and different background stiffnesses were scanned using a single ultrasound system under a fixed SWE protocol. Each phantom contained four embedded inclusions representing clinically relevant stiffness categories. Six breast imagers independently acquired repeated SWE measurements in transverse and longitudinal planes, blinded to lesion identity and ground truth. Inter-operator reproducibility was assessed using intraclass correlation coefficients, and was high across both phantom backgrounds, with low intra-operator variability following quality assurance exclusion of one dataset due to sampling error. Measurement variability was lowest for solid inclusions and increased for the cyst-like inclusion in the stiffer background. SWE measurements consistently preserved the relative stiffness ordering of inclusions, although absolute values differed systematically from mechanically derived ground-truth stiffness. These findings demonstrate that PVC-based polymer phantoms provide a stable and reproducible platform for evaluating SWE measurement behaviour under controlled conditions. By isolating operator and acquisition effects from biological variability, this polymer-based framework supports methodological standardisation and structured operator training in breast elastography.