Diagnostic performance of elastography for breast non-mass lesions: A systematic review and meta-analysis. Issue 144 (November 2021)

• Record Type: Journal Article
• Authors: Hong, Shaofu; Li, Weiyue; Gao, Wenjing; Liu, Mengmeng; Song, Di; Dong, Yinghui; Xu, Jinfeng; Dong, Fajin
• Is Part Of: European journal of radiology. Issue 144(2021)
• Publication Date: 2021-11
• Subjects: Breast non-mass lesion -- Diagnosis -- Elastography -- Meta-analysis; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2021.109991
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: It is the first study to perform meta-analysis of UE for differentiating breast NMLs. UE has high diagnostic accuracy in differentiating breast NMLs. UE can be a useful complement for conventional ultrasound in breast NMLs. Abstract: Purpose: This systematic review and meta-analysis aimed to evaluate the diagnostic performance of ultrasound elastography in the differentiation of benign and malignant breast non-mass lesions (NMLs). Methods: PubMed, Cochrane Library, and Embase databases were searched for eligible studies up to end of June 2021. The diagnostic performance of elastography for NMLs was investigated using pooled sensitivity and specificity, likelihood ratio, diagnostic odds ratio (DOR), post-test probability, and the area under hierarchical summary receiver operating characteristic curve (HSROC). Results: Eleven studies involving 812 NMLs (malignant 414) were included. The pooled sensitivity, specificity, DOR, positive likelihood ratio, and negative likelihood of elastography for the differentiation of benign and malignant breast NMLs were 79% (95 %CI: 71–85), 86% (95 %CI: 79–91), 23.32 (95 %CI: 13.38–40.66), 5.67 (95 %CI: 3.79–8.47), and 0.24 (95 %CI: 0.17–0.34), respectively. No significant publication bias existed. The area under the HSROC curve was 90% (95 %CI: 87–92). Fagan plots demonstrated good clinical utility. However, substantial heterogeneity existed. Country, measurement index, and number of lesions served as potential sources of heterogeneity. Conclusions: The results of this study suggest that elastography has high diagnostic accuracy in differentiating between malignant and benign NMLs. Elastography can be a feasible and non-invasive tool for breast NMLs.