Shear wave elastography and pulsed doppler for breast lesions: Similar diagnostic performance and positively correlated stiffness and blood flow resistance

Purpose: To compare the diagnostic performance of shear wave elastography (SWE) and pulsed Doppler ultrasound in breast lesions, and to explore whether the quantitative SWE parameters correlated with pulsed Doppler ultrasound parameters. Materials and methods: Seventy-nine patients with 79 breast lesions who had undergone conventional ultrasound, pulsed Doppler ultrasound and SWE examination were included. All of them underwent core needle biopsy or surgery within one week. Parameters including Emax (the maximum elastic modulus), Emean (mean elastic modulus), Emin (minimum elastic modulus), Esd (elastic modulus standard deviation), and RI (resistive index), PI (pulsatility index), PSV (peak systolic velocity) and EDV (end diastolic velocity) were obtained for statistical analysis. Results: Almost all SWE parameters were significantly different between benign and malignant breast lesions (P< 0.05). There was no significant difference between Esd and PI (P>0.05), which had the best AUC among SWE and vascular parameters respectively (0.877 vs. 0.871). Emax showed a moderate correlation with PI (P = 0.000, r = 0.552) and RI (P = 0.000, r = 0.544), and Esd moderately correlated with PI (P = 0.000, r = 0.567) and RI (P = 0.000, r = 0.546). For the benign group, no parameters showed any significant correlation (P>0.05), while for the malignant group, Emax and Esd also significantly correlated with PI or RI. Conclusions: SWE and pulsed Doppler ultrasound had similar diagnostic efficacy for breast lesions. SWE and pulsed Doppler parameters were significantly correlated in breast lesions, especially in malignant ones, indicating the potential association between elastographic and vascular characteristics of breast tumors.