ABSTRACT
PURPOSE: The aim of the present study was to determine the accuracy of breast cancer measurement with 2âD shear wave elastography (2âD SWE), B-mode ultrasound, and mammography by comparing these methods with the actual histopathological tumor size. MATERIALS AND METHODS: 135 patients with proven malignant breast lesions at two centers were included in a prospective study. The maximum lesion diameter was measured by 2âD SWE, B-mode ultrasound, and mammography. After surgery, the histopathological tumor size was measured by a pathologist. RESULTS: The mean difference in tumor size on 2âD SWE, B-mode ultrasound, and mammography on the one hand, and the actual tumor size on the other, was -0.03âcm, 0.16âcm and 0.10âcm, respectively. Lesion size on histopathological investigation was overestimated by 2âD SWE (pâ=â0.004) and underestimated by B-mode imaging (pâ<â0.001). All three imaging methods underestimated the size of invasive lobular cancers and lesions >â15âmm; 2âD SWE was most accurate in this regard. CONCLUSION: 2âD SWE predicted lesion size more precisely than B-mode ultrasound or mammography. In cases of invasive lobular carcinoma, all three imaging methods underestimated lesion size, with 2âD SWE coming closest to the actual tumor size.
Subject(s)
Breast Neoplasms , Elasticity Imaging Techniques , Ultrasonography, Mammary , Breast Neoplasms/diagnostic imaging , Female , Humans , Mammography , Prospective StudiesABSTRACT
BACKGROUND: Predicting the exact extent of a breast tumor is of great importance for oncologic treatment strategies. Different types of elastography can be used as new tools for measuring lesion size. PURPOSE: To provide evidence regarding the accuracy of tumor size measurement of strain elastography (SE), two-dimensional (2D) and three-dimensional (3D) shear wave elastography (SWE), and conventional B-image ultrasound. MATERIAL AND METHODS: In this prospective study, the diameter of 105 malignant breast lesions was measured by SE, 2D and 3D SWE, and B-mode ultrasound. The histopathological lesion size was compared to all imaging-based measuring methods. RESULTS: The mean lesion size of all breast carcinomas was 1.54 cm. B-mode ultrasound underestimates breast cancer size in 65.7 % of all cases in this study ( P < 0.0001). Mean lesion size was more accurately determined by SE, 2D and 3D SWE compared to B-mode ultrasound. Absolute differences between measured and actual lesion are smaller for B-mode ultrasound (0.26 cm) than for SE (0.41 cm) and 2D and 3D SWE (0.41 cm and 0.44 cm, respectively). CONCLUSION: B-mode ultrasound allows more accurate lesion size measurement than SE and 2D or 3D SWE but has a significantly higher risk of underestimating tumor size which could lead to incomplete margins during surgery. 3D SWE was not superior to 2D SWE or SE but by trend more precise in predicting the size of invasive lobular carcinoma.