TY - JOUR
T1 - Effect of calcifications on breast ultrasound shear wave elastography
T2 - An investigational study
AU - Gregory, Adriana
AU - Mehrmohammadi, Mohammad
AU - Denis, Max
AU - Bayat, Mahdi
AU - Stan, Daniela L.
AU - Fatemi, Mostafa
AU - Alizad, Azra
N1 - Publisher Copyright:
© 2015 Gregory et al.
PY - 2015/9/14
Y1 - 2015/9/14
N2 - Purpose To investigate the effects of macrocalcifications and clustered microcalcifications associated with benign breast masses on shear wave elastography (SWE). Methods SuperSonic Imagine (SSI) and comb-push ultrasound shear elastography (CUSE) were performed on three sets of phantoms to investigate how calcifications of different sizes and distributions influence measured elasticity. To demonstrate the effect in vivo, three female patients with benign breast masses associated with mammographically-identified calcifications were evaluated by CUSE. Results Apparent maximum elasticity (E max ) estimates resulting from individual macrocalcifications (with diameters of 2mm, 3mm, 5mm, 6mm, 9mm, 11mm, and 15mm) showed values over 50 kPa for all cases, which represents more than 100% increase over background (21kPa). We considered a 2cm-diameter circular region of interest for all phantom experiments. Mean elasticity (E mean ) values varied from 26 kPa to 73 kPa, depending on the macrocalcification size. Highly dense clusters of microcalcifications showed higher E max values than clusters of microcalcification with low concentrations, but the difference in E mean values was not significant. Conclusions Our results demonstrate that the presence of large isolated macrocalcifications and highly concentrated clusters of microcalcifications can introduce areas with apparent high elasticity in SWE. Considering that benign breast masses normally have significantly lower elasticity values than malignant tumors, such areas with high elasticity appearing due to presence of calcification in benign breast masses may lead to misdiagnosis.
AB - Purpose To investigate the effects of macrocalcifications and clustered microcalcifications associated with benign breast masses on shear wave elastography (SWE). Methods SuperSonic Imagine (SSI) and comb-push ultrasound shear elastography (CUSE) were performed on three sets of phantoms to investigate how calcifications of different sizes and distributions influence measured elasticity. To demonstrate the effect in vivo, three female patients with benign breast masses associated with mammographically-identified calcifications were evaluated by CUSE. Results Apparent maximum elasticity (E max ) estimates resulting from individual macrocalcifications (with diameters of 2mm, 3mm, 5mm, 6mm, 9mm, 11mm, and 15mm) showed values over 50 kPa for all cases, which represents more than 100% increase over background (21kPa). We considered a 2cm-diameter circular region of interest for all phantom experiments. Mean elasticity (E mean ) values varied from 26 kPa to 73 kPa, depending on the macrocalcification size. Highly dense clusters of microcalcifications showed higher E max values than clusters of microcalcification with low concentrations, but the difference in E mean values was not significant. Conclusions Our results demonstrate that the presence of large isolated macrocalcifications and highly concentrated clusters of microcalcifications can introduce areas with apparent high elasticity in SWE. Considering that benign breast masses normally have significantly lower elasticity values than malignant tumors, such areas with high elasticity appearing due to presence of calcification in benign breast masses may lead to misdiagnosis.
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U2 - 10.1371/journal.pone.0137898
DO - 10.1371/journal.pone.0137898
M3 - Article
C2 - 26368939
AN - SCOPUS:84947813127
SN - 1932-6203
VL - 10
JO - PloS one
JF - PloS one
IS - 9
M1 - e0137898
ER -