Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography

Mohamed Mohamed Hefeda; Mohammed Abdallah Hablus

doi:doi:10.11648/j.ijmi.20190702.13

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Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography

Mohamed Mohamed Hefeda, Mohammed Abdallah Hablus

Published in International Journal of Medical Imaging (Volume 7, Issue 2)

Received: 24 May 2019 Accepted: 8 July 2019 Published: 14 August 2019

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Abstract

The aim of this study was to evaluate the diagnostic performance of shear wave elastography by acoustic radiation force impulse (ARFI) elastography in differentiating malignant and benign breast Lesions in comparison with strain elastography and B mode ultrasound. This was prospective study, we used the commercially available eSie touch elastography imaging. In the shear wave elastography (SWE) we had two modes, the virtual touch imaging (VTI) with interpretation with the 5 points elasticity score and virtual touch quantification (VTQ) technique with the calculation of the Shear wave velocity (SWV). The study included 142 solid breast masses, of them 75 (52.8%) were benign and 67 (47.2%) were malignant. The mean shear wave velocity differed significantly between the benign and malignant groups (2.4+1.3m/sec and 7.3+2.2m/sec respectively, P value <0.0001). the sensitivity, specificity, PPV, NPV and accuracy of strain (eSie touch) elastography score was 83.1%, 88.73%, 88.06%, 84% and 85.92% respectively, which was less than the elastography score by ARFI (92.42%, 92.11%, 91.04%, 93.33% and 92.25% respectively) and less than the VTQ (SWV) which was 94.03%, 95.95%, 95.45% and 95.04% respectively. We concluded that Both the SWE and SE elastography showed significant difference between the benign and malignant masses, and both has added value above B mode ultrasound during routine examination. Shear wave elastography had higher sensitivity and specificity than SE, and less false negative and false positive results. The quantitative SWE (SWV) had the highest diagnostic performance among the different studied techniques.

Published in	International Journal of Medical Imaging (Volume 7, Issue 2)
DOI	10.11648/j.ijmi.20190702.13
Page(s)	44-56
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Breast Masses, Shear Wave Elastography, Strain Elastography, ARFI, VTQ

References

[1]	Ibraheem AS, Khaled HM, Mikhail NNH, Kamel H. Cancer incidence in Egypt: results of the national population –based cancer registry program. Journal of cancer epidemiology. 2014: article ID 437971. 18 pages.
[2]	Ferlay J, Shin HR, Bray F, Forman D, Mathers CD, Parkin D. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127: 2893–2917.
[3]	Checka CM, Chun JE, Schnabel FR, Lee J, Toth H. The relationship of mammographic density and age: implications for breast cancer screening. AJR Am J Roentgenol 2012; 198: W292–295.
[4]	Athanasiou A, Tardivon A, Tanter M, Sigal-Zafrani B, Bercoff J, Deffieux T, et al. Breast lesions: quantitative elastography with supersonic shear imaging--preliminary results. Radiology 2010; 256: 297-303.
[5]	Corsetti V, Ferrari A, Ghirardi M, Bergonzini R, Bellarosa S, Angelini O, et al. Role of ultrasonography in detecting mammographically occult breast carcinoma in women with dense breasts. Radiol Med 2006; 111: 440-8.
[6]	Yi A, Cho N, Chang JM, Koo HR, La Yun B, Moon WK. Sonoelastography for 1, 786 nonpalpable breast masses: diagnostic value in the decision to biopsy. Eur Radiol 2012; 22 (5): 1033–1040.
[7]	Sadigh G, Carlos RC, Neal CH, Dwamena BA. Ultrasonographic differentiation of malignant from benign breast lesions: a metaanalytic comparison of elasticity and BIRADS scoring. Breast Cancer Res Treat 2012; 133 (1): 23–35.
[8]	Burnside ES, Hall TJ, Sommer AM, et al. Differentiating benign from malignant solid breast masses with US strain imaging. Radiology 2007; 245 (2): 401–410.
[9]	Yoon JH, Kim MH, Kim EK, Moon HJ, Kwak JY, Kim MJ. Interobserver variability of ultrasound elastography: how it affects the diagnosis of breast lesions. AJR Am J Roentgenol 2011; 196 (3): 730–736.
[10]	Nightingale KR, McAleavey SA, Trachey GE. Shear wave generation using acoustic radiation force: in vivo and ex vivo results. Ultrasound Med Biol 2003; 29: 1715–1723.
[11]	Bercoff J, Tanter M, Muller M, Fink M. The role of viscosity in the impulse diffraction field of elastic waves induced by the acoustic radiation force. IEEE Trans Ultrason Ferroelectr Freq Control 2004; 51: 1523–1536.
[12]	Balleyguier C, Ciolovan L, Ammari S, et al. Breast elastography: the technical process and its applications. Diagn Interv Imaging. 2013; 94 (5): 503-513.
[13]	Bai M, Du L, Gu J, et al. Virtual Touch tissue quantification using acoustic radiation force impulse technology: initial clinical experience with solid breast masses. J Ultrasound Med. 2012; 31: (2): 289–294.
[14]	Goddi A, Bonardi M, Alessi S. Breast elastography: a literature review. J Ultrasound. 2012; 15: (3): 192–198.
[15]	Cosgrove DO, Berg WA, Doré CJ, et al. Shear wave elastography for breast masses is highly reproducible. Eur Radiol 2012; 22 (5): 1023–1032.
[16]	Barr RG. Sonographic breast elastography: a primer. J Ultrasound Med 2012; 31 (5): 773–783.
[17]	Ciurea AI, Bolboaca SD, Ciortea CA, BotarJid C, Dudea SM. The influence of technical factors on sonoelastographic assessment of solid breast nodules. Ultraschall Med 2011; 32 (Suppl 1): S27–S34.
[18]	Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology2006; 239: 341–350.
[19]	Cho N, Moon WK, Park JS. Real-time US elastography in the differentiation of suspicious microcalcifications on mammography. Eur Radiol 2009; 19: 1621–1628.
[20]	Berg WA, Cosgrove DO, Doré CJ, et al. Shearwave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses. Radiology 2012; 262: 435–449.
[21]	Chang JM, Moon WK, Cho N, et al. Clinical application of shear wave elastography (SWE) in the diagnosis of benign and malignant breast diseases. Breast Cancer Res Treat 2011; 129: 89–97.
[22]	Athanasiou A, Tardivon A, Tanter M, et al. Breast lesions: Quantitative elastography with supersonic shear imaging—preliminary results. Radiology 2010; 256: 297–303.
[23]	D’Orsi CJ, Bassett LW, Berg WA, et al. BI-RADS: mammography, 4th ed. In: D’Orsi CJ, Mendelson EB, Ikeda DM, et al., eds. Breast Imaging Reporting and Data System: ACR BI-RADS—breast imaging atlas. Reston, VA: American College of Radiology, 2003.
[24]	Kim YS, Park JG, Kim BS, Lee CH, Ryu DW. Diagnostic value of elastography using acoustic radiation force impulse imaging and strain ratio for breast tumors. J Breast Cancer. 2014 Mar; 17 (1): 76-82. March; 17 (1): 76-82.
[25]	Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology 2006; 239: 341–350.
[26]	Jayaraman J, Indiran V, Kannan K, et al. (June 01, 2017) Acoustic Radiation Force Impulse Imaging in Benign and Malignant Breast Lesions. Cureus 9 (6): e1301. DOI 10.7759/cureus. 1301.
[27]	Tozaki M, Isobe S, Fukuma E: Preliminary study of ultrasonographic tissue quantification of the breast using the acoustic radiation force impulse (ARFI) technology. Eur J Radiol. 2011, 80: 182–187. 10.1016/j.ejrad.2011.05.020.
[28]	Zhi H, Ou B, Xiao XY, Peng YL, Wang Y, Liu LS, et al. Ultrasound elastography of breast lesions in chinese women: a multicenter study in China. Clin Breast Cancer 2013; 13: 392-400.
[29]	Gheonea IA, Stoica Z, Bondari S. Differential diagnosis of breast lesions using ultrasound elastography. Indian J Radiol Imaging 2011; 21: 301-5.
[30]	Tozaki M, Isobe S, Sakamoto M. Combination of elastography and tissue quantification using the acoustic radiation force impulse (ARFI) technology for differential diagnosis of breast masses. Jpn J Radiol 2012; 30: 659-70.
[31]	Meng W, Zhang G, Wu C, Wu G, Song Y, Lu Z. Preliminary results of acoustic radiation force impulse (ARFI) ultrasound imaging of breast lesions. Ultrasound Med Biol 2011; 37 (9): 1436—43.
[32]	Barr RG. Real-time ultrasound elasticity of the breast: initial clinical results. Ultrasound Q 2010; 26 (2): 61–66.
[33]	Barr RG, Destounis S, Lackey LB 2nd, Svensson WE, Balleyguier C, Smith C. Evaluation of breast lesions using sonographic elasticity imaging: a multicenter trial. J Ultrasound Med 2012; 31 (2): 281–287.
[34]	Ueno E, Umemoto T, Bando H, Tohno E, Waki K, Matsumura T. New quantitative method in breast elastography: fat lesion ratio (FLR) [abstr]. In: Radiological Society of North America scientific assembly and annual meeting program. Oak Brook, Ill: Radiological Society of North America, 2007; 697.
[35]	Destounis S, Arieno A, Morgan R, et al. Clinical experience with elasticity imaging n a community-based breast center. J Ultrasound Med 2013; 32 (2): 297–302.
[36]	Raza S, Odulate A, Ong EM, Chikarmane S, Harston CW. Using real-time tissue elastography for breast lesion evaluation: our initial experience. J Ultrasound Med 2010; 29 (4): 551–563.
[37]	Thomas A, Degenhardt F, Farrokh A, Wojcinski S, Slowinski T, Fischer T. Significant differentiation of focal breast lesions: calcuation of strain ratio in breast sonoelastography. Acad Radiol 2010; 17 (5): 558–563.
[38]	Chang JM, Won JK, Lee KB, Park IA, Yi A, and Moon WK. Comparison of Shear-Wave and Strain Ultrasound Elastography in the Differentiation of Benign and Malignant Breast Lesions American Journal of Roentgenology 2013 201: 2, W347-W356.
[39]	Evans A, Whelehan P, Thomson K, et al. Differentiating benign from malignant solid breast masses: value of shear wave elastography according to leion stiffness combined with greyscale ultrasound according to BI-RADS classification. Br J Cancer 2012; 107: 224–229.
[40]	Cho N, Moon WK, Park JS, Cha JH, Jang M, Seong MH. Nonpalpable breast masses: evaluation by US elastography. Korean J Radiol 2008; 9: 111–118 41. Barr RG, Zhang Z. Effects of precompression on elasticity imaging of the breast: development of a clinically useful semiquantitative method of precompression assessment. J Ultrasound Med 2012; 31: 895–902.
[41]	Seo M, Ahn HS, Park SH, Lee JB, Choi BI, Sohn YM, Shin SY. Comparison and Combination of Strainand Shear Wave Elastography of Breast Masses for Differentiation of Benign and Malignant Lesions by Quantitative Assessment: Preliminary Study. J Ultrasound Med. 2018 Jan; 37 (1): 99-109.
[42]	Fujioka T, Mori M, Kubota K, Kikuchi Y, Katsuta L, Kasahara M, Oda G, Ishiba T, Nakagawa T, Tateishi U. Simultaneous comparison between strain and shear wave elastography of breast masses for the differentiation of benign and malignant lesions by qualitative and quantitative assessments. Breast Cancer. 2019 Jun 7. doi: 10.1007/s12282-019-00985-0.
[43]	Silva P, Uscategui RAR, Maronezi MC, Gasser B, Pavan L, Gatto IRH, de Almeida VT, et al. Ultrasonography for lymph nodes metastasis identification in bitches with mammary neoplasms. ScientIfic reports (2018) 8: 17708 \| DOI: 10.1038/s41598-018-34806-9.
[44]	Choi JJ, Kang BJ, Kim SH, Lee JH, Jeong SH, Yim HW, et al. Role of sonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer. J Ultrasound Med 2011; 30 (4): 429—36.

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APA Style

Mohamed Mohamed Hefeda, Mohammed Abdallah Hablus. (2019). Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography. International Journal of Medical Imaging, 7(2), 44-56. https://doi.org/10.11648/j.ijmi.20190702.13

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ACS Style

Mohamed Mohamed Hefeda; Mohammed Abdallah Hablus. Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography. Int. J. Med. Imaging 2019, 7(2), 44-56. doi: 10.11648/j.ijmi.20190702.13

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AMA Style

Mohamed Mohamed Hefeda, Mohammed Abdallah Hablus. Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography. Int J Med Imaging. 2019;7(2):44-56. doi: 10.11648/j.ijmi.20190702.13

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@article{10.11648/j.ijmi.20190702.13,
  author = {Mohamed Mohamed Hefeda and Mohammed Abdallah Hablus},
  title = {Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography},
  journal = {International Journal of Medical Imaging},
  volume = {7},
  number = {2},
  pages = {44-56},
  doi = {10.11648/j.ijmi.20190702.13},
  url = {https://doi.org/10.11648/j.ijmi.20190702.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20190702.13},
  abstract = {The aim of this study was to evaluate the diagnostic performance of shear wave elastography by acoustic radiation force impulse (ARFI) elastography in differentiating malignant and benign breast Lesions in comparison with strain elastography and B mode ultrasound. This was prospective study, we used the commercially available eSie touch elastography imaging. In the shear wave elastography (SWE) we had two modes, the virtual touch imaging (VTI) with interpretation with the 5 points elasticity score and virtual touch quantification (VTQ) technique with the calculation of the Shear wave velocity (SWV). The study included 142 solid breast masses, of them 75 (52.8%) were benign and 67 (47.2%) were malignant. The mean shear wave velocity differed significantly between the benign and malignant groups (2.4+1.3m/sec and 7.3+2.2m/sec respectively, P value <0.0001). the sensitivity, specificity, PPV, NPV and accuracy of strain (eSie touch) elastography score was 83.1%, 88.73%, 88.06%, 84% and 85.92% respectively, which was less than the elastography score by ARFI (92.42%, 92.11%, 91.04%, 93.33% and 92.25% respectively) and less than the VTQ (SWV) which was 94.03%, 95.95%, 95.45% and 95.04% respectively. We concluded that Both the SWE and SE elastography showed significant difference between the benign and malignant masses, and both has added value above B mode ultrasound during routine examination. Shear wave elastography had higher sensitivity and specificity than SE, and less false negative and false positive results. The quantitative SWE (SWV) had the highest diagnostic performance among the different studied techniques.},
 year = {2019}
}

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TY  - JOUR
T1  - Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography
AU  - Mohamed Mohamed Hefeda
AU  - Mohammed Abdallah Hablus
Y1  - 2019/08/14
PY  - 2019
N1  - https://doi.org/10.11648/j.ijmi.20190702.13
DO  - 10.11648/j.ijmi.20190702.13
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 44
EP  - 56
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20190702.13
AB  - The aim of this study was to evaluate the diagnostic performance of shear wave elastography by acoustic radiation force impulse (ARFI) elastography in differentiating malignant and benign breast Lesions in comparison with strain elastography and B mode ultrasound. This was prospective study, we used the commercially available eSie touch elastography imaging. In the shear wave elastography (SWE) we had two modes, the virtual touch imaging (VTI) with interpretation with the 5 points elasticity score and virtual touch quantification (VTQ) technique with the calculation of the Shear wave velocity (SWV). The study included 142 solid breast masses, of them 75 (52.8%) were benign and 67 (47.2%) were malignant. The mean shear wave velocity differed significantly between the benign and malignant groups (2.4+1.3m/sec and 7.3+2.2m/sec respectively, P value <0.0001). the sensitivity, specificity, PPV, NPV and accuracy of strain (eSie touch) elastography score was 83.1%, 88.73%, 88.06%, 84% and 85.92% respectively, which was less than the elastography score by ARFI (92.42%, 92.11%, 91.04%, 93.33% and 92.25% respectively) and less than the VTQ (SWV) which was 94.03%, 95.95%, 95.45% and 95.04% respectively. We concluded that Both the SWE and SE elastography showed significant difference between the benign and malignant masses, and both has added value above B mode ultrasound during routine examination. Shear wave elastography had higher sensitivity and specificity than SE, and less false negative and false positive results. The quantitative SWE (SWV) had the highest diagnostic performance among the different studied techniques.
VL  - 7
IS  - 2
ER  -

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Author Information

Mohamed Mohamed Hefeda

Radiology Department, Tanta University, Tanta, Egypt
Mohammed Abdallah Hablus

Department of general surgery Faculty of Medicine, Tanta University, Tanta, Egypt

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APA Style

Mohamed Mohamed Hefeda, Mohammed Abdallah Hablus. (2019). Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography. International Journal of Medical Imaging, 7(2), 44-56. https://doi.org/10.11648/j.ijmi.20190702.13

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ACS Style

Mohamed Mohamed Hefeda; Mohammed Abdallah Hablus. Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography. Int. J. Med. Imaging 2019, 7(2), 44-56. doi: 10.11648/j.ijmi.20190702.13

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AMA Style

Mohamed Mohamed Hefeda, Mohammed Abdallah Hablus. Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography. Int J Med Imaging. 2019;7(2):44-56. doi: 10.11648/j.ijmi.20190702.13

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@article{10.11648/j.ijmi.20190702.13,
  author = {Mohamed Mohamed Hefeda and Mohammed Abdallah Hablus},
  title = {Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography},
  journal = {International Journal of Medical Imaging},
  volume = {7},
  number = {2},
  pages = {44-56},
  doi = {10.11648/j.ijmi.20190702.13},
  url = {https://doi.org/10.11648/j.ijmi.20190702.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20190702.13},
  abstract = {The aim of this study was to evaluate the diagnostic performance of shear wave elastography by acoustic radiation force impulse (ARFI) elastography in differentiating malignant and benign breast Lesions in comparison with strain elastography and B mode ultrasound. This was prospective study, we used the commercially available eSie touch elastography imaging. In the shear wave elastography (SWE) we had two modes, the virtual touch imaging (VTI) with interpretation with the 5 points elasticity score and virtual touch quantification (VTQ) technique with the calculation of the Shear wave velocity (SWV). The study included 142 solid breast masses, of them 75 (52.8%) were benign and 67 (47.2%) were malignant. The mean shear wave velocity differed significantly between the benign and malignant groups (2.4+1.3m/sec and 7.3+2.2m/sec respectively, P value <0.0001). the sensitivity, specificity, PPV, NPV and accuracy of strain (eSie touch) elastography score was 83.1%, 88.73%, 88.06%, 84% and 85.92% respectively, which was less than the elastography score by ARFI (92.42%, 92.11%, 91.04%, 93.33% and 92.25% respectively) and less than the VTQ (SWV) which was 94.03%, 95.95%, 95.45% and 95.04% respectively. We concluded that Both the SWE and SE elastography showed significant difference between the benign and malignant masses, and both has added value above B mode ultrasound during routine examination. Shear wave elastography had higher sensitivity and specificity than SE, and less false negative and false positive results. The quantitative SWE (SWV) had the highest diagnostic performance among the different studied techniques.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Diagnostic Accuracy of Shear Wave Elastography in Differentiation Between Benign and Malignant Solid Breast Masses Compared with Strain Elastography
AU  - Mohamed Mohamed Hefeda
AU  - Mohammed Abdallah Hablus
Y1  - 2019/08/14
PY  - 2019
N1  - https://doi.org/10.11648/j.ijmi.20190702.13
DO  - 10.11648/j.ijmi.20190702.13
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 44
EP  - 56
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20190702.13
AB  - The aim of this study was to evaluate the diagnostic performance of shear wave elastography by acoustic radiation force impulse (ARFI) elastography in differentiating malignant and benign breast Lesions in comparison with strain elastography and B mode ultrasound. This was prospective study, we used the commercially available eSie touch elastography imaging. In the shear wave elastography (SWE) we had two modes, the virtual touch imaging (VTI) with interpretation with the 5 points elasticity score and virtual touch quantification (VTQ) technique with the calculation of the Shear wave velocity (SWV). The study included 142 solid breast masses, of them 75 (52.8%) were benign and 67 (47.2%) were malignant. The mean shear wave velocity differed significantly between the benign and malignant groups (2.4+1.3m/sec and 7.3+2.2m/sec respectively, P value <0.0001). the sensitivity, specificity, PPV, NPV and accuracy of strain (eSie touch) elastography score was 83.1%, 88.73%, 88.06%, 84% and 85.92% respectively, which was less than the elastography score by ARFI (92.42%, 92.11%, 91.04%, 93.33% and 92.25% respectively) and less than the VTQ (SWV) which was 94.03%, 95.95%, 95.45% and 95.04% respectively. We concluded that Both the SWE and SE elastography showed significant difference between the benign and malignant masses, and both has added value above B mode ultrasound during routine examination. Shear wave elastography had higher sensitivity and specificity than SE, and less false negative and false positive results. The quantitative SWE (SWV) had the highest diagnostic performance among the different studied techniques.
VL  - 7
IS  - 2
ER  -

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