Aishwarya Pillai, Teja Voruganti, Richard Barr, Jonathan Langdon
{"title":"剪切波弹性成像对女性乳腺病变特征的诊断准确性:系统回顾与元分析》。","authors":"Aishwarya Pillai, Teja Voruganti, Richard Barr, Jonathan Langdon","doi":"10.1016/j.jacr.2022.02.022","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to assess the diagnostic accuracy of 2-D shear-wave elastography (SWE) for differentiating benign and malignant breast lesions in women with abnormal findings on mammography.</p><p><strong>Methods: </strong>Included in this review are studies of diagnostic accuracy published before June 2021 using 2-D SWE to evaluate female breast lesions. Included studies were required to include at least 50 lesions, report quantitative shear-wave speed (SWS) thresholds, and include a reference standard of either biopsy or 2-year stability. Included studies used the mean, maximum, minimum, or SD of SWS for classification. A systematic search of PubMed, Scopus, Embase, Ovid-MEDLINE, the Cochrane Library, and Web of Science was performed. Bias and applicability of the studies were assessed using Quality Assessment of Diagnostic Accuracy Studies 2. A hierarchical summary receiver operating characteristic model was used to arrive at the summary statistics.</p><p><strong>Results: </strong>Eighty-seven prospective and retrospective studies were included, encompassing 17,810 women (mean age 42.3 ± 10.4 years) with 19,043 lesions (7,623 malignant). Summary sensitivities and specificities, respectively, were 0.86 (95% confidence interval [CI], 0.83-0.88) and 0.87 (95% CI, 0.84-0.88) for mean SWS, 0.83 (95% CI, 0.80-0.85) and 0.88 (95% CI, 0.86-0.90) for the maximum, 0.86 (95% CI, 0.74-0.93) and 0.81 (95% CI, 0.69-0.89) for the minimum, and 0.82 (95% CI, 0.77-0.86) and 0.88 (95% CI, 0.85-0.91) for the SD. Alternatively, the areas under the receiver operating characteristic curve were 0.93 (95% CI, 0.91-0.94), 0.92 (95% CI, 0.90-0.94), 0.90 (95% CI, 0.82-0.96), and 0.92 (95% CI, 0.88-0.94), respectively.</p><p><strong>Conclusions: </strong>This review demonstrates the discriminative power of SWE in the diagnosis of breast cancer. Using the resulting likelihood ratios, SWE may prove beneficial in downgrading BI-RADS® 4a or upgrading BI-RADS 3 lesions. However, current society guidelines do not provide definitive recommendations regarding the use of SWE and its counterpart strain elastography (SE). Comparison with our results suggests that SE alone or a combination of SE and SWE may provide better diagnostic performance than SWE alone and serve as an adjunct to current diagnostic techniques.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic Accuracy of Shear-Wave Elastography for Breast Lesion Characterization in Women: A Systematic Review and Meta-Analysis.\",\"authors\":\"Aishwarya Pillai, Teja Voruganti, Richard Barr, Jonathan Langdon\",\"doi\":\"10.1016/j.jacr.2022.02.022\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The aim of this study was to assess the diagnostic accuracy of 2-D shear-wave elastography (SWE) for differentiating benign and malignant breast lesions in women with abnormal findings on mammography.</p><p><strong>Methods: </strong>Included in this review are studies of diagnostic accuracy published before June 2021 using 2-D SWE to evaluate female breast lesions. Included studies were required to include at least 50 lesions, report quantitative shear-wave speed (SWS) thresholds, and include a reference standard of either biopsy or 2-year stability. Included studies used the mean, maximum, minimum, or SD of SWS for classification. A systematic search of PubMed, Scopus, Embase, Ovid-MEDLINE, the Cochrane Library, and Web of Science was performed. Bias and applicability of the studies were assessed using Quality Assessment of Diagnostic Accuracy Studies 2. A hierarchical summary receiver operating characteristic model was used to arrive at the summary statistics.</p><p><strong>Results: </strong>Eighty-seven prospective and retrospective studies were included, encompassing 17,810 women (mean age 42.3 ± 10.4 years) with 19,043 lesions (7,623 malignant). Summary sensitivities and specificities, respectively, were 0.86 (95% confidence interval [CI], 0.83-0.88) and 0.87 (95% CI, 0.84-0.88) for mean SWS, 0.83 (95% CI, 0.80-0.85) and 0.88 (95% CI, 0.86-0.90) for the maximum, 0.86 (95% CI, 0.74-0.93) and 0.81 (95% CI, 0.69-0.89) for the minimum, and 0.82 (95% CI, 0.77-0.86) and 0.88 (95% CI, 0.85-0.91) for the SD. Alternatively, the areas under the receiver operating characteristic curve were 0.93 (95% CI, 0.91-0.94), 0.92 (95% CI, 0.90-0.94), 0.90 (95% CI, 0.82-0.96), and 0.92 (95% CI, 0.88-0.94), respectively.</p><p><strong>Conclusions: </strong>This review demonstrates the discriminative power of SWE in the diagnosis of breast cancer. Using the resulting likelihood ratios, SWE may prove beneficial in downgrading BI-RADS® 4a or upgrading BI-RADS 3 lesions. However, current society guidelines do not provide definitive recommendations regarding the use of SWE and its counterpart strain elastography (SE). Comparison with our results suggests that SE alone or a combination of SE and SWE may provide better diagnostic performance than SWE alone and serve as an adjunct to current diagnostic techniques.</p>\",\"PeriodicalId\":73968,\"journal\":{\"name\":\"Journal of the American College of Radiology : JACR\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American College of Radiology : JACR\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jacr.2022.02.022\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/3/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American College of Radiology : JACR","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.jacr.2022.02.022","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/3/28 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Diagnostic Accuracy of Shear-Wave Elastography for Breast Lesion Characterization in Women: A Systematic Review and Meta-Analysis.
Purpose: The aim of this study was to assess the diagnostic accuracy of 2-D shear-wave elastography (SWE) for differentiating benign and malignant breast lesions in women with abnormal findings on mammography.
Methods: Included in this review are studies of diagnostic accuracy published before June 2021 using 2-D SWE to evaluate female breast lesions. Included studies were required to include at least 50 lesions, report quantitative shear-wave speed (SWS) thresholds, and include a reference standard of either biopsy or 2-year stability. Included studies used the mean, maximum, minimum, or SD of SWS for classification. A systematic search of PubMed, Scopus, Embase, Ovid-MEDLINE, the Cochrane Library, and Web of Science was performed. Bias and applicability of the studies were assessed using Quality Assessment of Diagnostic Accuracy Studies 2. A hierarchical summary receiver operating characteristic model was used to arrive at the summary statistics.
Results: Eighty-seven prospective and retrospective studies were included, encompassing 17,810 women (mean age 42.3 ± 10.4 years) with 19,043 lesions (7,623 malignant). Summary sensitivities and specificities, respectively, were 0.86 (95% confidence interval [CI], 0.83-0.88) and 0.87 (95% CI, 0.84-0.88) for mean SWS, 0.83 (95% CI, 0.80-0.85) and 0.88 (95% CI, 0.86-0.90) for the maximum, 0.86 (95% CI, 0.74-0.93) and 0.81 (95% CI, 0.69-0.89) for the minimum, and 0.82 (95% CI, 0.77-0.86) and 0.88 (95% CI, 0.85-0.91) for the SD. Alternatively, the areas under the receiver operating characteristic curve were 0.93 (95% CI, 0.91-0.94), 0.92 (95% CI, 0.90-0.94), 0.90 (95% CI, 0.82-0.96), and 0.92 (95% CI, 0.88-0.94), respectively.
Conclusions: This review demonstrates the discriminative power of SWE in the diagnosis of breast cancer. Using the resulting likelihood ratios, SWE may prove beneficial in downgrading BI-RADS® 4a or upgrading BI-RADS 3 lesions. However, current society guidelines do not provide definitive recommendations regarding the use of SWE and its counterpart strain elastography (SE). Comparison with our results suggests that SE alone or a combination of SE and SWE may provide better diagnostic performance than SWE alone and serve as an adjunct to current diagnostic techniques.