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This study aimed to identify the associated factors for quality measurement (QM) of shear wave speed (SWS) imaging and to validate the additional value of QM in the diagnosis of breast lesions. From September 2014 to February 2015, conventional ultrasound and SWS imaging were performed in 338 women with 361 breast lesions. Binary logistic regression was used to identify associated factors for QM. Sensitivity, specificity and the area under receiver operating characteristic (ROC) curve (AUC) among maximum SWS (SWS  max  ), QM and SWS  max   plus QM (SWS  max  +QM) were compared to validate additional value of QM. Pathology confirmed 263 (72.9%) benign lesions and 98 (27.1%) malignancies. Maximum depth (Odds ratio [OR]: 1.398) and posterior features (OR: 1.206) were identified as independent associated factors for QM. Compared with SWS  max   and QM, the sensitivity of SWS  max  +QM increased from 67.3%, 64.3% to 83.7% whereas the specificity decreased from 90.5%, 72.6% to 65.4% (all  P  < 0.05). SWS  max   had the highest AUC in comparison with QM and SWS  max  +QM (0.849 vs. 0.685 vs. 0.745;  P  < 0.05). QM for breast lesions is associated with maximum depth and posterior features. Adding QM to SWS  max   is useful for breast cancer screening and SWS  max   alone is useful for breast cancer differentiation.

Quality Measurement of Two-dimensional Shear Wave Speed Imaging for Breast Lesions: the Associated Factors and the Impact to Diagnostic Performance