Magnetic resonance imaging and shear wave elastography comparison in the evaluation of breast lesions

Magnetic Resonance Imaging (MRI) is used with assistive imaging methods such as mammography and ultrasonography in the examination of breast lesions. Additional findings from mammography and ultrasonography on breast MRI are needed due to the distinction limitations between benign and malignant lesions. Shear Wave Elastography (SWE) is an up-to-date method that contributes to the lesion characterization of B-mode ultrasonography and provides information about quantitative data and tissue stiffness. The aims of this study are to compare the MRI and SWE data and investigate the contribution of these imaging techniques to diagnosis when both are together and seperately used. This study included the consents of patients whom required diagnostic biopsy, after their breast MRI examination performed at Fırat University Hospital between January 2019 and May 2020. Patients with a mass appearance suitable for sonographic evaluation were SWE examined before biopsy. From the MR examination of 46 patients, lesion localization, size, contrast curves, contrast enhancement features, intensity in the fat-suppressed T2A sequence, Emean value in terms of kPa in the SWE examination and histopathological results were examined. In our study, MRI and SWE findings were internally and mutually evaluated with histopathological results. After the separate and together evaluation of SWE and MRI results the consistency of diagnosis was compared according to the histopathological results of the malignant-benign defined lesions. As a result of our comparison, the sensitivity of MRI and the specificity and accuracy of SWE were found to be higher than the other. The accuracy of MRI was increased, when SWE was included in the evaluation along with MRI. Also, statistically significant increase was found in elastography values compared to the internal other parameters of cases showed Type3 enhancement curve and iso-hypointense on T2 weighted sequence. In conclusion, we observed that the mutual use of SWE with MRI increases the diagnosis accuracy in the characterization of breast lesions. As an additional finding we observed that lesions showing Type 3 enhancement curve in breast MRI and iso- and hypointense on the T2W sequence can be predicted to show a hard elasticity pattern on SWE. Keywords: Breast lesions, Magnetic Resonance Imaging, Shear Wave Elastography