Comparing the Accuracy of Shear Wave Elastography and Strain Elastography in the Diagnosis of Breast Tumors: A Systematic Review and Meta-Analysis

Background: Shear wave elastography (SWE) and strain elastography (SE) are 2 new ultrasonic technologies which have developed rapidly in recent years. Elastography transforms the elastic information of tissue into optical information for display, thus more intuitive display of tissue elasticity. Conflicting results have been obtained in different scholars’ studies on the accuracy comparison of the 2 elastography technologies in the diagnosis of breast tumors. This meta-analysis aims to compare the accuracy of the 2 elastography technologies in the diagnosis of breast tumors, and provide a reference for clinical decision making. Methods: We have searched Chinese and English literatures on the accuracy of SWE and SE in the diagnosis of breast tumors from PubMed, Web of Science, China national knowledge infrastructure and Wanfang databases, and the time was up to December30, 2020. Two literature reviewers screened the literatures according to the screening criteria, and Quality Assessment of Diagnostic Accuracy Study tool was used to evaluate the quality of included literatures. Meta Disc1.4 and Stata14.0 softwares were used to perform heterogeneity test, sensitivity analysis and publication bias test. Results: Ten literatures included 1599 patients and 1709 breast lesions. The final results in the SWE as follow: The pooled sensitivity was 0.852 (95% confidence interval [CI] [0.826–0.874]), the pooled specificity (Spe) was 0.799 (95% CI [0.776–0.820]), the pooled positive likelihood ratio was 4.758 (95% CI [3.443–6.576]), the pooled negative likelihood ratio was 0.192 (95% CI [0.147–0.250]), the pooled diagnostic odds ratio was 29.071 (95% CI [16.967–49.811]), and the area under the summary receiver operating characteristic curve was 0.9159. The final results in the SE as follow: The pooled sensitivity was 0.843 (95% CI [0.817–0.866]), the pooled Spe was 0.766 (95% CI [0.743–0.789]), the pooled positive likelihood ratio was 4.387 (95% CI [3.088–6.233]), the pooled negative likelihood ratio was 0.216 (95% CI [0.179–0.261]), the pooled diagnostic odds ratio was 22.610 (95% CI [15.622–32.724]), and the area under the summary receiver operating characteristic curve was 0.8987. Conclusion: The sensitivity and Spe of SWE were higher than those of SE, suggesting that SWE may have a higher accuracy in the diagnosis of breast tumors. Register name: PROSPERO. Registration number: CRD42021251110.