Intra- and Interobserver Reliability of Shear Wave Elastography in Breast Cancer Diagnosis

J Ultrasound Med. 2024 Jan;43(1):109-114. doi: 10.1002/jum.16344. Epub 2023 Sep 29.

Abstract

Objectives: Shear wave elastography (SWE) is increasingly used in breast cancer diagnostics. However, large, prospective, multicenter data evaluating the reliability of SWE is missing. We evaluated the intra- and interobserver reliability of SWE in patients with breast lesions categorized as BIRADS 3 or 4.

Methods: We used data of 1288 women at 12 institutions in 7 countries with breast lesions categorized as BIRADS 3 to 4 who underwent conventional B-mode ultrasound and SWE. 1243 (96.5%) women had three repetitive conventional B-mode ultrasounds as well as SWE measurements performed by a board-certified senior physician. 375 of 1288 (29.1%) women received an additional ultrasound examination with B-mode and SWE by a second physician. Intraclass correlation coefficients (ICC) were calculated to examine intra- and interobserver reliability.

Results: ICC for intraobserver reliability showed an excellent correlation with ICC >0.9, while interobserver reliability was moderate with ICC of 0.7. There were no clinically significant differences in intraobserver reliability when SWE was performed in lesions categorized as BI-RADS 3 or 4 as well as in histopathologically benign or malignant lesions.

Conclusion: Reliability of additional SWE was evaluated on a study cohort consisting of 1288 breast lesions categorized as BI-RADS 3 and 4. SWE shows an excellent intraobserver reliability and a moderate interobserver reliability in the evaluation of solid breast masses.

Keywords: B-mode ultrasound; breast cancer; reliability; shear wave elastography.

Publication types

  • Multicenter Study

MeSH terms

  • Breast / diagnostic imaging
  • Breast / pathology
  • Breast Neoplasms* / diagnostic imaging
  • Breast Neoplasms* / pathology
  • Diagnosis, Differential
  • Elasticity Imaging Techniques*
  • Female
  • Humans
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Ultrasonography, Mammary