Rationale and Objectives
To investigate the efficacy of the advanced imaging methods, superb microvascular
imaging (SMI) and shear wave elastography (SWE) in predicting molecular subtypes in
invasive breast carcinomas.
Materials and Methods
A total of 210 biopsy-proven breast carcinomas in 200 patients who underwent ultrasound
(US) imaging with SMI and SWE were included in this study. Quantitative analyses were
performed using mean elasticity (Emean) score by SWE and vascular index (VI) by SMI. For qualitative assessment of microvascularity,
first, lesions were graded according to Adler's classification in four types. Then,
a new morphological model was used to classify the microvascular architecture into
six patterns: type one, no signal; type two, penetrant; type three, rim-like; type
four, dot-like/linear/regional; type five, wheel-like and type six, irregular signals.
The correlation between these variables and molecular subtypes, nuclear grade, the
Ki-67 levels and axillary status was investigated.
Results
The average VI and Emean values were relatively higher in non-luminal subtypes (VI, p = 0.002; Emean, p > 0.05). The two microvascularisation models were significantly able to differentiate
the molecular subtypes according to the Kruskal Wallis test (p < 0.05). Rim-like, penetrant and regional patterns were primarily observed in luminal
subtypes. The dominant pattern in non-luminal subtypes was wheel-like pattern. VI,
Emean, Adler's classification and morphological vascularisation model were not significantly
correlated with the nuclear grade, Ki-67 index or axillary status.
Conclusion
The proposed microvascular categorization model may be more valuable in predicting
molecular subtypes of breast carcinomas compared to VI and Emean and may contribute to the management of breast carcinomas as a non-invasive variable.
Key Words
Abbreviations:
BI-RADS (breast imaging-reporting and data system), cSMI (color mode superb microvascular imaging), Emean (mean elasticity), ER (estrogen receptor), HER2 (human epidermal growth factor receptor 2), mSMI (monochromatic mode superb microvascular imaging), PR (progesterone receptor), ROI (region of interest), SMI (superb microvascular imaging), SWE (shear wave elastography), TNBC (tripple negative breast cancer), US (ultrasound), VI (vascular index)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: June 03, 2022
Accepted:
April 16,
2022
Received in revised form:
April 7,
2022
Received:
March 22,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
