Ultrasound shear-wave elasticity and magnetic resonance diffusion coefficient show strong inverse correlation in small fibroadenomas

Year 2021, Volume: 34 Issue: 1, 24 - 28, 29.01.2021

Nurten Andac Baltacıoglu Derya Turelı

https://doi.org/10.5472/marumj.866519

Cited By: 1

Abstract

Objective: Stiffness of breast lesions helps distinguish malignant from benign solid masses. Stiffness can be quantitatively measured
by magnetic resonance and ultrasound imaging using apparent diffusion coefficient (ADC) and shear-wave elastography (SWE)
techniques, respectively. This study aims to analyze correlations between SWE and ADC in biopsy-proven small fibroadenomas.
Patients and Methods: Shear-wave elastography and ADC measurements of 50 fibroadenomas were evaluated retrospectively. Mean
patient age was 41±13 years (range 27-63). All lesions had maximum diameters of ≤20 millimeters. Correlations between intralesional
ADC, lesion-parenchyma ADC ratio, intralesional SWE, SWE heterogeneity index and lesion volume were analyzed.
Results: Mean values of lesions were as follows: ADC=1.71±0.22 x10-3mm2/s, ADC ratio=1.04±0.09, maximum SWE=73.4±28.8
kPa, minimum SWE=43.9±21.8 kPa and SWE heterogeneity index =29.4±12.7 kPa. There was a strong inverse correlation between
fibroadenoma ADC and SWE values (rho = – 0.746, p <0.01). Significant correlations were also found between fibroadenoma volume
and ADC (rho = – 0.525, p <0.05) and SWE (rho = 0.840, p <0.01).
Conclusion: Apparent diffusion coefficient and SWE values show strong inverse correlation in small fibroadenomas. If proven
threshold values for lesion characterization are revealed, ultrasonographic SWE and diffusion-weighted MRI have potential to be
used interchangeably.

Keywords

Apparent diffusion coefficient, Fibroadenoma of breast, Magnetic resonance imaging, Ultrasound shear-wave elastography

References

• Iima M, Honda M, Sigmund EE, Ohno Kishimoto A, Kataoka M, Togashi K. Diffusion MRI of the breast: Current status and future directions. J Magn Reson Imaging 2020;52:70-90. doi: 10.1002/jmri.26908.
• Barr RG. Sonographic breast elastography: a primer. J Ultrasound Med 2012;31:773-83. doi: 10.7863/ jum.2012.31.5.773.
• Matsubayashi RN, Imanishi M, Nakagawa S, et al. Breast ultrasound elastography and magnetic resonance imaging of fibrotic changes of breast disease: correlations between elastography findings and pathologic and short Tau inversion recovery imaging results, including the enhancement ratio and apparent diffusion coefficient. J Comput Assist Tomogr 2015;39:94-101. doi: 10.1097/RCT.000.000.0000000155.
• Elseedawy M, Whelehan P, Vinnicombe S, Thomson K, Evans A. Factors influencing the stiffness of fibroadenomas at shear wave elastography. Clin Radiol 2016;71:92-5. doi: 10.1016/j. crad.2015.10.029.
• Evans A, Whelehan P, Thomson K, et al. Quantitative shear wave ultrasound elastography: initial experience in solid breast masses. Breast Cancer Res 2010;12:R104. doi: 10.1186/ bcr2787.
• Skerl K, Vinnicombe S, Giannotti E, Thomson K, Evans A. Influence of region of interest size and ultrasound lesion size on the performance of 2D shear wave elastography (SWE) in solid breast masses. Clin Radiol 2015;70:1421-7. doi: 10.1016/j. crad.2015.08.010.
• Athanasiou A, Tardivon A, Tanter M, et al. Breast lesions: quantitative elastography with supersonic shear imaging— preliminary results. Radiology 2010;256:297-303. doi: 10.1148/radiol.10090385.
• Berg WA, Cosgrove DO, Doré CJ, et al. Shear-wave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses. Radiology 2012;262:435- 49. doi: 10.1148/radiol.11110640.
• Tanter M, Bercoff J, Athanasiou A, et al. Quantitative assessment of breast lesion viscoelasticity: initial clinical results using supersonic shear imaging. Ultrasound Med Biol 2008;34:1373-86. doi: 10.1016/j.ultrasmedbio.2008.02.002.
• 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:e182-7. doi: 10.1016/j.ejrad.2011.05.020.
• 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;37:1436- 43. doi: 10.1016/j.ultrasmedbio.2011.05.022.
• Vinnicombe SJ, Whelehan P, Thomson K, McLean D, Purdie CA, Jordan LB, et al. What are the characteristics of breast cancers misclassified as benign by quantitative ultrasound shear wave elastography? Eur Radiol 2014;24:921-6. doi: 10.1007/s00330.013.3079-4.