Benefit of Shear-wave Elastography in the differential diagnosis of breast lesion: A diagnostic meta-analysis

Abstract

Aims: The purpose of this diagnostic meta-analysis was to explore the benefit of shear wave elastography (SWE) combinedly used with conventional ultrasound (US) in the diagnosis of the benign and malignant breast lesion. Material and methods: After a literature search on MEDLINE, Cochrane library, and Embase we included 14 studies with a total 1951 patients and 2060 breast lesions for further analyses. Summary descriptive statistics such as pooled sensitivity, specificity, and summary receiver operating characteristics curve were generated via a bivariate random effect model. Summary indicators such as area under curve (AUC) and confident region were used to compare the performance of conventional US and combination of conventional US and shear wave imaging (SWI) or two-dimensional and three-dimensional SWI. Results: As indicated by the results, the pooled sensitivity, specificity, and diagnostic odds ratio for combined usage of SWE and the conventional US were 0.877 (95%CI: 0.855-0.896) and 0.849 (95%CI: 0.826-0.869) and 40.164 (95%CI:31.135- 51.811). The AUC for combined use and the conventional US only were 0.928 and 0.899, suggesting a promise of integrating SWE in the routine of breast lesion examination. Also, the summary AUC for 2D and 3D SWE were 0.917 and 0.952 respectively. No significant difference was found between 2D and 3D SWE. No obvious publication bias was identified after employing Deeks' regression test for asymmetry. Conclusion: Our analysis concluded that SWE improved the differential diagnosis of the breast lesion.