Comparative analysis of conventional ultrasound and shear wave elastography features in primary breast diffuse large B-cell lymphoma

Table 1 Clinical characteristics of patients with primary breast diffuse large B-cell lymphoma

Variable	Value
No. of patients	32
Age (yr)	mean ± SD: 56.6 ± 12.4; Range: 32-78
Sex	Female: 28 (87.5%); Male: 4 (12.5%)
Tumor size (cm)	mean ± SD: 4.2 ± 2.1; Range: 1.5-9
Treatment modalities	Chemotherapy alone: 8 (25%); Chemotherapy + rituximab: 16 (50%); Chemotherapy + radiotherapy: 6 (18.8%); Chemotherapy + rituximab + radiotherapy: 2 (6.3%)
Ki-67 expression level (%)	Mean ± SD: 68.4 ± 21.6; Range: 20-95
Follow-up duration (mo)	Median: 24; Range: 6-60
Survival status	Dead: 8 (25%); Alive with disease: 6 (18.8%); Alive without disease: 18 (56.3%)

Table 2 Conventional ultrasound features of primary breast diffuse large B-cell lymphoma lesions

Feature	PB-DLBCL (n = 32), n (%)	Benign (n = 32), n (%)	P value	AUC
Shape			< 0.001	0.799
Round/oval	5 (15.6)	24 (75)
Irregular	27 (84.4)	8 (25)
Margin			< 0.001	0.750
Circumscribed	8 (25)	28 (87.5)
Microlobulated/spiculated/indistinct/angular	24 (75)	4 (12.5)
Orientation			0.003	0.637
Parallel	21 (65.6)	30 (93.8)
Non-parallel	11 (34.4)	2 (6.3)
Echo			< 0.001	0.688
Anechoic/hyperechoic/isoechoic	4 (12.5)	16 (50)
Hypoechoic	28 (87.5)	16 (50)
Posterior acoustic features			< 0.001	0.812
None/shadowing/combined pattern	11 (34.4)	26 (81.3)
Enhancement	21 (65.6)	6 (18.8)
Calcification			> 0.05	NA
Present	2 (6.3)	4 (12.5)
Absent	30 (93.8)	28 (87.5)
Vascularity			< 0.001	0.612
Avascular	10 (31.3)	18 (56.3)
Hypovascular	12 (37.5)	14 (43.8)
Hypervascular	10 (31.3)	0 (0)

PB-DLBCL: Primary breast diffuse large B-cell lymphoma; AUC: Area under the curve; NA: Not available.

Table 3 Shear wave elastography features of primary breast diffuse large B-cell lymphoma lesions

Feature	PB-DLBCL (n = 32)	Benign (n = 32)	P value	AUC
	mean ± SD/range	mean ± SD/range
Mean elasticity value (kPa)	113.4 ± 46.9/(42-212)	27.8 ± 16.4/(9-68)	< 0.001	0.969
Standard deviation (kPa)	29.6 ± 14/(11-64)	11 ± 6/(4-28)	< 0.001	0.875
Minimum elasticity value (kPa)	51 ± 21/(19-97)	13 ± 7/(5-34)	< 0.001	0.906
Maximum elasticity value (kPa)	175 ± 67/(82-321)	46 ± 23/(18-98)	< 0.001	0.938
Ratio of lesion to fat	7.1 ± 3.2/(2.6-14.5)	1.8 ± 0.9/(0.7-4.2)	< 0.001	0.812

PB-DLBCL: Primary breast diffuse large B-cell lymphoma; AUC: Area under the curve.

Table 4 Mean elasticity value and Ki-67 expression level of primary breast diffuse large B-cell lymphoma lesions

Ki-67 expression level (%)	Mean elasticity value (kPa)
20	42
25	46
30	51
35	55
40	59
45	64
50	68
55	73
60	78
65	83
70	88
75	93
80	98
85	103
90	108
95	113

Table 5 Overall survival and progression-free survival of primary breast diffuse large B-cell lymphoma patients according to the mean elasticity value of primary breast diffuse large B-cell lymphoma lesions

Time (mo)	High-stiffness group OS (%)	High-stiffness group PFS (%)	Low-stiffness group OS (%)	Low-stiffness group PFS (%)
0	100	100	100	100
6	87.5	75	93.8	87.5
12	75	62.5	87.5	81.3
18	62.5	50	81.3	75
24	50	37.5	75	68.8
30	37.5	25	68.8	62.5
36	25	12.5	62.5	56.3
42	12.5	0	56.3	50
48	0	NA	50	43.8
54	NA	NA	43.8	NA
60	NA	NA	NA	NA

OS: Overall survival; PFS: Progression-free survival; NA: Not available.