Background: Shear Wave Elastography (SWE) estimates the stiffness of a mass based on the velocity of Shear Wave propagation by sound Waves. Due to higher cell density and angiogenesis, malignant masses have higher stiffness than benign ones. Methods: The present study was a prospective study and was performed on patients who were referred to Ahvaz Golestan Hospital with breast mass during March 2020 to March 2021. Only patients with 4-5 BI-RAD were evaluated. Patients were graded based on ACR BI-RAD. All patients were subjected to ultrasound and selection of BIRAD 4-5 patients for evaluation with SWE and sampling for pathology testing. In this study, in order to increase the maximum accuracy and take samples from the main location of the lesion, sampling was done by ultrasound-guided biopsy method. Tumor information was recorded by a specialist doctor after ultrasound and SWE. This information included tumor type, tumor size and grade, presence of metastasis, involvement of lymph nodes, average and maximum elasticity. SWE cutoffs were compared for mean and maximum elasticity to distinguish benign from malignant masses. Results: In this study, 115 patients were evaluated. 63. 5% (73) of the patients had benign mass and 36. 5% (42) had malignant ones. There was a significant relationship between tumor size and mean and maximum elasticity (P<0. 001 The results showed that the diagnostic accuracy of SWE in identifying malignant masses compared to benign ones was 100%, so that the mean (16. 61±, 8. 03 kPa) and maximum (21. 14±, 8. 88 kPa) elasticity in benign masses were significantly lower than the mean (32. 21±, 7. 59 kPa) and maximum (91. 62±, 8. 84 kPa) elasticity of malignant masses (P<0. 001). There was also a significant difference between the 4 BI-RAD subgroups, so that in BI-RAD 4a, the lowest mean and maximum elasticity were seen (P<0. 001). Conclusion: The results showed that SWE parameters have sufficient diagnostic accuracy in diagnosing malignant breast masses. Therefore, the use of quantitative SWE parameters in conjunction with ultrasound and BI-RADS classification can avoid unnecessary biopsies.

Background: Changes in tendon structure are expected in chronic renal failure (CRF) due to metabolic alterations. Shear-Wave Elastography (SWE) is a new Elastography technique that determines soft tissue elasticity noninvasively. SWE may determine early tendon degeneration due to CRF. Objectives: We aim to determine Achilles tendon thickness and elasticity in CRF patients undergoing hemodialysis with B-mode and SWE ultrasonography (US). Patients and Methods: Thirty-four (23 male, 11 female) patients with CRF and 32 healthy individuals (24 male, eight female) were included in the study. Initially both Achilles tendons of patients were evaluated for structural abnormalities or focal lesions then tendon thickness was measured with B-mode US. Tendon stiffness was measured by SWE in kilopascal (kPa) units. Results: Mean Achilles tendon thickness in the patient group was significantly lower than the control group (4. 16  0. 59 mm vs. 4. 78 0. 61 mm, P < 0. 001). The mean elasticity scores in the patient group was 26. 00 9. 74 kPa and 24. 64 6. 64 kPa in the control group which was not statistically significant. Conclusion: Achilles tendon is thinner in chronic renal failure patients compared to the control group. However, there was no significant difference between the groups in stiffness values of tendons measured by SWE.

Background: The effect of microWave ablation on small hepatocellular carcinoma is not significantly different from that of surgical resection. Accurate assessment of the ablation effect is crucial for ensuring the safety and effectiveness of hyperthermia. Objectives: This study aimed to explore the feasibility and accuracy of supersonic Shear Wave Elastography (SWE) in quantitatively evaluating the microWave ablation margin of the liver. Materials and Methods: Three surgeons were each randomly assigned 4 Wuzhishan miniature pigs (WZSPs) to perform 12 ablation procedures at an ablation power of 40 W. Based on the ablation time, the lesions were divided into 15, 30, and 60-second groups. Immediately after ablation, SWE and modulus measurements were performed 5 times for each ablation lesion. The SWE data were expressed as mean ± standard deviation. Within-group and between-group comparisons were made using repeated measures analysis of variance. Results: A total of 144 effective ablations and 131 effective pathological results were obtained. Within the same ablation time, the elastic modulus increased in the surrounding normal tissue, ablation margin, and ablation center regions in a stepwise manner (P < 0.01). However, in the ablation center region, the elastic modulus decreased in a stepwise manner with the shortening of ablation time [60 s (97.16 ± 14.58 kPa) > 30 s (77.84 ± 9.64 kPa) > 15 s (38.92 ± 3.12 kPa)], with statistically significant differences (F = 2,131.832, P < 0.01). The elastic modulus of the ablation margin region at different ablation times remained between 22.68 - 23.56 kPa. Conclusion: The elastic modulus range in the ablation margin region after microWave ablation is relatively fixed. Shear Wave Elastography aids in the quantitative evaluation of the ablation margin region of the liver and has high practical value in monitoring and evaluating ultrasound ablation.

Background: This study aims to evaluate the role of Shear Wave Elastography (SWE) in the differentiation of malignant from benign cervical lymph nodes and compare its accuracy with conventional ultrasound. Methods: Seventy-one lymph nodes (malignant=52, benign=19) were investigated by both conventional sonography and SWE. Shear Wave Velocity (SWV) and color map were obtained for each lymph node before tissue sampling. R statistical software (x64, v3.6.1) was used for statistical analysis. Results: Among all the conventional and Elastography features, color map grading and Shear Wave velocity (SWV) had the most correlation with malignancy, even in normal-sized nodes. SWV was significantly correlated with the pathology (rpb=0.62, p<0.00). The best cutoff-value for SWV was 2.71 m/s (sensitivity: 82.7%, specificity:84.2%, AUC=0.92). The best predicting model by multivariate analysis was obtained by a combination of SWV and color map grading (sensitivity=92.3%, specificity=94.7%). Conclusion: SWE is a valuable method for the differentiation of malignant from benign lymph nodes. It would help to find the proper lymph node for biopsy.

Background: Elastography is a non-invasive diagnostic imaging technique that assesses the elasticity or stiffness of tissues. This study aimed to compare the diagnostic performance of Shear Wave Elastography (SWE) and Strain Elastography (SE) in distinguishing benign from malignant breast masses.Methods: In a retrospective study, 447 women with breast masses were evaluated divided into two groups: 223 underwent SE, and 224 underwent SWE. Histopathological findings served as the gold standard. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and Receiver Operating Characteristic (ROC) curves were calculated for both techniques. Data analysis was performed using R software (version 4.3), with t-tests and chi-square tests for group comparisons.Results: The mean age of participants was 46.1±9.8 years. Significant differences were observed between the benign and malignant groups in terms of age, mass size, and family history of breast cancer (p<0.05). For SWE, sensitivity, specificity, PPV, and NPV were 92, 93, 89, and 95%, respectively, compared to 85, 87, 82, and 89%, respectively for SE. The diagnostic accuracy of SWE was higher than SE (93 vs. 86%). The area under the ROC curve was 0.94 for SWE and 0.88 for SE.Conclusion: SWE demonstrated superior diagnostic performance compared to SE in differentiating benign and malignant breast masses. This non-invasive technique can serve as a valuable clinical tool to improve diagnostic accuracy for malignancies and reduce unnecessary biopsies. However, multicenter studies with larger, more diverse samples are needed to validate these findings.