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Ultraschall Med 2017; 38(01): 51-59
DOI: 10.1055/s-0034-1398980
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Feasibility of Imaging and Treatment Monitoring of Breast Lesions with Three-Dimensional Shear Wave Elastography

Durchführbarkeit und Therapie-Monitoring von Brustläsionen mittels dreidimensionaler Scherwellen-Elastografie
Alexandra Athanasiou
1   Radiology, Institut Curie, Paris, France
,
Heldmuth Latorre-Ossa
2   ESPCI, Institut Langevin, Paris, France
,
Aline Criton
3   Supersonic Imagine, SuperSonic Imagine, Aix-en-Provence, France
,
Anne Tardivon
1   Radiology, Institut Curie, Paris, France
,
Jean-Luc Gennisson
2   ESPCI, Institut Langevin, Paris, France
,
Mickael Tanter
2   ESPCI, Institut Langevin, Paris, France
› Author Affiliations
Further Information

Publication History

21 February 2014

08 January 2015

Publication Date:
05 March 2015 (online)

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Abstract

Purpose Firstly to evaluate the feasibility and diagnostic performance of three-dimensional (3 D) shear wave elastography (SWE) volume measurements in patients with breast lesions compared to breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) lesion volumes and 3D-US B-mode volumes. Secondly to assess the treatment monitoring performance of 3D-SWE in patients under neoadjuvant chemotherapy for breast cancer by comparing it to 3D-US lesion volume.

Materials and Methods This prospective study was approved by the institutional review board. Informed consent was provided. 33 patients with 33 lesions were included. The feasibility of 3D-SWE was evaluated in 23 patients. In the 10 remaining patients receiving neoadjuvant chemotherapy, 3D-SWE was evaluated before and during treatment. Tumor volume and qualitative and quantitative elasticity analysis measurements were performed and compared to the tumor volume as estimated by 3D-US and DCE-MRI. Statistical analysis was performed using the Pearson correlation coefficient.

Results 3D-SWE was feasible in patients with breast lesions. Tumor volume calculated with 3D-US and 3D-SWE showed very good and moderate concordances with DCE-MRI volume, respectively (Pearson correlation coefficients equal to ρ = r = 0.88, p < 0.00 002 and ρ = r = 0.5, p = 0.32, respectively). Modification of tumor elasticity and heterogeneity was correlated with response to treatment. In good responders, elasticity and elasticity heterogeneity diminished.

Conclusion Tumor 3D-US volume measurements showed very good concordance with DCE-MRI volume. 3D-SWE can provide valuable information: reduction of tissue stiffness during treatment could be a potential indicator of response. These preliminary results should be confirmed on a larger number of patients.

Zusammenfassung

Ziel Erstens die Bewertung der Durchführbarkeit und der diagnostischen Leistung von Volumenmessungen mittels dreidimensionaler (3D) Scherwellen-Elastografie bei Patienten mit Brustläsionen im Vergleich zur den Läsions-Volumen mittels brustdynamischer kontrastverstärkter Magnetresonanztomografie (DCE-MRT) und den Volumen im 3D-US-B-Modus. Zweitens die Analyse der Leistung eines Therapie-Monitoring durch 3D-SWE bei Patienten mit neoadjuvanter Chemotherapie des Brustkrebses im Vergleich zum 3D-US-Läsionsvolumen.

Material und Methoden Diese prospektive Studie wurde durch das Prüfungskomitee des Instituts genehmigt. Die Einwilligung der Patienten lag vor. Eingeschlossen wurden 33 Patienten mit 33 Läsionen. Untersucht wurde die Durchführbarkeit der 3D-SWE an 23 Patienten. Bei weiteren 10 Patienten, die eine neoadjuvante Chemotherapie erhielten, wurde die 3D-SWE vor und während der Therapie ausgewertet. Bestimmungen des Tumorvolumens und der qualitativen und quantitativen Elastizitätsanalyse wurden durchgeführt und mit dem im 3D-US und DCE-MRT abgeschätzten Tumorvolumen verglichen. Die statistische Analyse erfolgte mittels Pearson’s Korrelationskoeffizient.

Ergebnisse Die 3D-SWE war bei Patienten mit Brustläsionen machbar. Die Übereinstimmung des errechneten Tumorvolumen im Vergleich zum DCE-MRT-Volumen war für den 3D-US sehr gut (Pearson’s Korrelationskoeffizient ρ = r = 0,88; p = 0,00 002) und für die 3D-SWE moderat (ρ = r = 0,5; p = 0,32). Eine Modifikation der Tumorelastizität und Heterogenität korrelierte mit dem Ansprechen auf die Therapie. Bei Patienten mit gutem Ansprechen verringerte sich die Elastizität und die elastische Heterogenität.

Schlussfolgerung Die Volumenbestimmung des Tumors durch 3D-US zeigte eine sehr gute Übereinstimmung mit dem DCE-MRT-Volumen. Die 3D-SWE kann wertvolle Informationen bieten: Eine Reduktion der Gewebe-Steifigkeit unter Therapie kann ein möglicher Hinweis auf Ansprechen sein. Diese vorläufigen Ergebnisse sollten an einer größeren Patientenzahl bestätigt werden.

Key words

breast - tumor - 3D ultrasound - neoadjuvant chemotherapy
 

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