Diagnostic Accuracy of Sonoelastography for Breast Lesions: A Meta-Analysis Comparing Strain and Shear Wave Elastography

Abstract

This meta-analysis evaluated the diagnostic accuracy of sonoelastography for distinguishing benign and malignant breast lesions, comparing strain elastography and shear wave elastography (SWE). We systematically reviewed 825 publications, selecting 30 studies (6200 lesions: 45% benign, 55% malignant). The pooled sensitivity and specificity for overall sonoelastography were 88% (95% CI: 85–91%) and 84% (95% CI: 81–87%), respectively. Strain elastography showed sensitivity and specificity of 85% and 80%, respectively, while SWE demonstrated superior performance with 90% sensitivity, 86% specificity, and an AUC of 0.92. Moderate heterogeneity (I2 = 55%) was attributed to study variation. SWE showed the potential to reduce unnecessary biopsies by 30–40% by increasing specificity. AI-assisted image analysis and standardized protocols may enhance accuracy and reduce variability. These findings support the integration of SWE into breast imaging protocols.