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Advanced Ultrasound in Diagnosis and Therapy ›› 2025, Vol. 9 ›› Issue (3): 270-276.doi: 10.26599/AUDT.2025.250075

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  • 收稿日期:2024-12-15 修回日期:2025-02-14 接受日期:2025-03-04 出版日期:2025-09-30 发布日期:2025-10-13

Ultrasound Viscoelasticity for Breast Tumor: High Diagnostic Performance at the Peritumoral Boundary

Shi Junnia,1, Xu Jiatonga,1, Chen Chuanjiana, Xiang Guanghuaa, Zheng Wena, Chen Mana,*()   

  1. aDepartment of Ultrasound, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Received:2024-12-15 Revised:2025-02-14 Accepted:2025-03-04 Online:2025-09-30 Published:2025-10-13
  • Contact: Department of Ultrasound, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Shanghai, China. e-mail:maggiech1221@126.com(M C)
  • About author:First author contact:Junni Shi and Jiatong Xu contributed equally to this study.

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Abstract:

Objectives Conventional ultrasound (US) elastography lacks specificity in distinguishing benign from malignant breast lesions. This study employed US to assess breast tissue viscosity and elasticity. The primary objective was to evaluate the diagnostic performance of US-derived viscoelasticity parameters. Secondary objectives included investigating the consistency of parameters in the mechanical properties of breast tissue.
Materials and methods Two doctors independently measured the viscosity and elasticity of specific positions in the breasts of 20 health females for consistency assessment. Then the doctors selected region of interest (ROI) to measure viscoelasticity. ROI-1, ROI-2, and ROI-3 represent the tumor, peritumoral, and peripheral areas, respectively. The viscosity modulus and elasticity modulus of 3 ROIs were analyzed. The viscosity and elasticity parameters with the highest area under the curve (AUC) were selected as the optimal ones. Finally, elasticity and viscosity parameters were combined to assess their diagnostic performance in differentiating breast lesions.
Results US viscoelasticity parameters can be measured with high consistency. Among conventional US elasticity parameters, 1-Emax demonstrated the highest AUC (0.746) for differentiating benign and malignant breast lesions. In US viscoelasticity parameters, 2-Emax achieved the highest AUC of 0.801, while 2-Vmax showed the highest AUC of 0.835. The highest specificity (0.903) was observed when both 2-Emax and 2-Vmax exceeded their respective cutoff values (P < 0.05 for all).
Conclusion Quantitative ultrasound viscoelasticity parameters play a crucial role in breast cancer diagnosis, with tumor boundary parameters being particularly significant for cancer screening and prevention strategies.

Key words: Viscoelasticity, Viscosity, Elasticity, Ultrasound, Breast cancer

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ItemsMean ± SD
Pathological diagnosis (n = 2613)
Benign2054 (78.6%)
Malignant559 (21.4%)
Age (y)45 ± 16
Menarche age (y)14 ± 2
Menopause age (n = 513, y)51 ± 4
First childbearing age (n = 2016, y)25 ± 7
1-Emean (kPa)40.0 ± 14.3
1-Emax (kPa)106.4 ± 56.3
1-Emin (kPa)13.0 ± 9.3
1-ESD (kPa)10.3 ± 3.5

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ItemsMean ± SD
Pathological diagnosis (n = 377)
Benign258 (68.4%)
Malignant119 (31.6%)
Age (y)48 ± 15
Menarche age (y)14 ± 2
Menopause age (n = 114, y)51 ± 3
First childbearing age (n = 308, y)25 ± 7
1-Emean (kPa)20.3 ± 12.6
1-Emax (kPa)92.5 ± 70.4
1-Emin (kPa)4.1 ± 3.6
1-ESD (kPa)12.3 ± 9.2
2-Emean (kPa)30.3 ± 47.4
2-Emax (kPa)38.0 ± 45.1
2-Emin (kPa)20.1 ± 22.9
2-ESD (kPa)5.3 ± 9.4
3-Emean (kPa)14.4 ± 10.8
3-Emax (kPa)17.5 ± 13.3
3-Emin (kPa)11.2 ± 7.9
3-ESD (kPa)1.7 ± 2.3
1-Vmean (Pa.s)2.5 ± 1.7
1-Vmax (Pa.s)9.1 ± 6.8
1-Vmin (Pa.s)0.4 ± 1.4
1-VSD (Pa.s)1.4 ± 0.9
2-Vmean (Pa.s)2.8 ± 3.1
2-Vmax (Pa.s)3.8 ± 4.0
2-Vmin (Pa.s)1.9 ± 2.2
2-VSD (Pa.s)0.5 ± 0.7
3-Vmean (Pa.s)1.3 ± 1.3
3-Vmax (Pa.s)1.7 ± 1.7
3-Vmin (Pa.s)1.0 ± 1.0
3-VSD (Pa.s)0.2 ± 0.3

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ItemsCut off (kPa)SensitivitySpecificityAUCP value
1-Emean360.7620.4170.609< 0.001
1-Emax800.8780.4290.746< 0.001
1-Emin470.0020.9980.307< 0.001

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ItemsCut offSensitivitySpecificityAUCP value
Elasticity (kPa)
2-Emean380.5210.9450.773< 0.001
2-Emax360.6120.8750.801< 0.001
2-Emin240.5450.8860.736< 0.001
Viscosity (Pa.s)
2-Vmean30.6170.8860.827< 0.001
2-Vmax30.7170.8460.835< 0.001
2-Vmin20.5420.9230.756< 0.001

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ItemsP valueSensitivitySpecificityAUC
2-Emax ≥ 36 kPa and 2-Vmax ≥ 3Pa.s< 0.0010.5970.9030.75
2-Emax ≥ 36 kPa or 2-Vmax ≥ 3Pa.s< 0.0010.7390.7910.765
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