Abstract PO1-07-06: Sonographic assessment of breast implants using strain elastography and shear wave elastography in an animal model
Authors: Fritsch Hanna , Celik Melisa , Warm Matthias , Thangarajah Fabinshy , Pisek Anett , Eichler Christian 
Published: May 2024

Abstract
Purpose: To date, MRI remains the gold standard for the diagnosis of breast implant rupture. As MRI is an expensive procedure with limited availability, improvement in sonographic assessment is desirable. A potentially useful tool in this regard is the assessment of tissue stiffness using ultrasound elastography. Strain elastography provides a qualitative analysis by producing a coloured map in the B-mode image comparing the stiffness of adjacent tissues in the region of interest, whereas shear wave elastography provides a quantitative analysis. To evaluate the diagnostic utility of both methods under standardised conditions, we developed an animal model. Under natural conditions, the physiology of the patient (e.g. the amount and stiffness of the breast tissue covering the implant in question) can influence the measurements and alter the data. Therefore, the animal model provides an excellent opportunity to compare ruptured and intact implants of different types and sizes under exactly the same conditions, neglecting individual characteristics of real patients. Methods: An animal model was created by preparing an implant site in a chicken breast, mimicking the layers of tissue typically covering a breast implant after mastectomy (skin, fat, muscle). Different fractured and intact implants were inserted. Measurements were made using strain elastography and shear wave elastography by an investigator with no further experience of breast ultrasound. Implants were scanned in five pre-defined planes in both intact and ruptured conditions. For strain elastography, the resulting images were examined for repetitive patterns. Shear wave elastography data were analysed for significant differences between ruptured and intact implants. Results: The chicken breast animal model produced realistic images and measurements comparable to those of a human breast. Therefore, ruptured and intact implants could be compared under standardised conditions. Statistical analysis showed no significant difference between intact and ruptured implants in shear wave elastography data. However, qualitative analysis using strain wave elastography showed different patterns when comparing intact and ruptured implants in the animal model. Intact implants showed a characteristic three-layer sonographic image at certain levels. Conclusion: Shear wave elastography does not appear to provide reliable data for the evaluation of breast implants, whereas qualitative analysis using strain wave elastography may be a useful tool to improve diagnostic accuracy.
Citation Format: Hanna Fritsch, Melisa Celik, Matthias Warm, Fabinshy Thangarajah, Anett Pisek, Christian Eichler. Sonographic assessment of breast implants using strain elastography and shear wave elastography in an animal model [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-07-06.