Breast SWE 2016's Top 5 Clinical Publications

#1

Prediction of invasive breast cancer using shear-wave elastography in patients with biopsy-confirmed ductal carcinoma in situ. Bae JS, Chang JM, Lee SH, Shin SU, Moon WK. Eur Radiol. 2017 Jan;27(1):7-15.
https://www.ncbi.nlm.nih.gov/pubmed/27085697

This article confirms the fact that IDC tend to be stiffer than DCIS. The clinical impact of this finding may be huge, because, as concluded by Bae and colleagues, "In patients with DCIS confirmed through US-guided core needle biopsy, stiffness values on SWE [may] help achieve a
proper one-step operation when performing surgical excision [...]"

Now that the demonstration of specificity increase of breast ultrasound has been globally accepted, thanks to the combination of SWE parameters to the BI-RADS classification, this is another relevant clinical area where SWE may bring value: can SWE predict in advance the presence of an invasive component along with a biopsy-proven DCIS? Results on this topic has already been specifically reported by 3 articles.

#2
Comparison of strain and shear-wave ultrasounic elastography in predicting the pathological response to neoadjuvant chemotherapy in breast cancers. Ma Y, Zhang S, Li J, Li J, Kang Y, Ren W. Eur Radiol. 2016 Oct 17.
https://www.ncbi.nlm.nih.gov/pubmed/27821323

Being able to predict and to follow-up the response of invasive breast cancers to neoadjuvant chemotherapy stands as a significant need for breast oncologists. The use of SWE in this context has been evaluated by 7 studies already, which tend to conclude that high stiffness values or non decreasing stiffness values could be interpreted as a sign of resistance to chemotherapy treatment. This article report the results of a very well done study, which looked at the best timing of such SWE evalutation during treatment monitoring and compared SWE with the strain ratio from strain elastography.

#3
Additional diagnostic value of shear-wave elastography and color Doppler US for evaluation of breast non-mass lesions detected at B-mode US. Choi JS, Han BK, Ko EY, Ko ES, Shin JH, Kim GR. Eur Radiol. 2016 Oct;26(10):3542-9.
https://www.ncbi.nlm.nih.gov/pubmed/26787603

Non-mass breast lesions (NMLs) are very often excluded from clinical studies, although they are more challenging in their morphological evaluation. This is the 2nd article published by the same team on NMLs, which cleverly combined SWE information with Doppler information to reach an increase in ultrasound specificity from 24% up to 69%, without any loss in sensitivity (100%). This impressive result tend to make SWE an indispensable tool in the ultrasound evaluation of NMLs.

#4
Shear-wave sonoelastographic features of invasive lobular breast cancers. Brkljačić B, Divjak E, Tomasović-Lončarić Č, Tešić V, Ivanac G. Croat Med J. 2016 Feb;57(1):42-50.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800323/pdf/CroatMedJ_57_0042.pdf

Invasive Lobular Carcinomas (ILC) are far less common than Invasive Ductal Carcinomas (IDC), and they are therefore less studied as a direct consequence. This report from a retrospective study dedicated to ILC is worth mentioning here: conclusions are that ILC tend to stiffer than IDC, especially the ones that are 15 mm or less in size on ultrasound. 

#5
3-Dimensional shear wave elastography of breast lesions: Added value of color patterns with emphasis on crater sign of coronal plane. Chen YL, Chang C, Zeng W, Wang F, Chen JJ, Qu N. Medicine (Baltimore). 2016 Sep;95(39):e4877.
http://journals.lww.com/md-journal/pages/articleviewer.aspx?year=2016&issue=09270&article=00030&type=abstract

Whether 3D imaging brings a benefit to the ultrasound diagnosis of breast lesions is an ongoing (and probably endless) debate. In this article, Chen and colleagues report interesting results of the combination of conventional ultrasound imaging with the evaluation of the "crater" sign obtained in the coronal plane using 3D-SWE. These results open the door to the use of 3D-SWE in the diagnostic framework, considering the coronal SWE map, with increased diagnostic performances. However, this study considered the transition between BIRADS 4a and 4b as the relevant cutoff, which does not reflect clinical practice (follow-up or biopsy?).

ECR 2015 Symposium invitation

Liver SWE, the 60 second assessment

Liver SWE !

SWE in RSNA - Breast 1

http://www.european-hospital.com/en/article/11627-Liver_fibrosis_emerges_as_a_breakthrough_for_elastography.html

Only with Aixplorer : 3 NEW White Papers for ShearWave Elastography on Liver

http://www.ncbi.nlm.nih.gov/pubmed/23453381

Ultrasound Med Biol. 2013 Jun;39(6):935-40. doi: 10.1016/j.ultrasmedbio.2012.12.009. Epub 2013 Feb 27.

Quantitative shear wave elastography in the evaluation of metastatic cervical lymph nodes.

Choi YJ, Lee JH, Lim HK, Kim SY, Han MW, Cho KJ, Baek JH.

Source

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Abstract

Our aim was to compare the diagnostic performance of shear wave elastography (SWE) with that of gray-scale ultrasound (US) in differentiating metastatic from benign lymph nodes in patients with head and neck malignancies. Maximum shear elasticity modulus (maxSM) was measured on SWE. The reference standard was pathologic diagnosis after surgery. We examined 67 lymph nodes (34 metastatic, 33 benign) from 15 patients (8 men and 7 women; mean age, 54.2 years). The maxSM value was significantly higher for metastatic than benign lymph nodes (41.06 ± 36.34 kPa vs. 14.22 ± 4.19 kPa, p < 0.0001) at a cutoff level of 19.44 kPa. Accuracy, sensitivity and specificity were 94, 91 and 97%, respectively, for SWE, and 91, 88 and 94%, respectively, for gray-scale US. Multiple regression analysis showed that the maxSM value (r = 0.882) and gray-scale US criteria (r = 0.837) were independent variables. SWE may be a valuable quantitative reproducible method for characterizing cervical lymph nodes.

Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

PMID:

 

23453381

 

[PubMed - in process]