Ultrasound Shear Wave Elastography in Oncology: Principles, Performance, and Clinical Applications: A Review

Shear wave elastography (SWE) has emerged as a significant advancement in ultrasound imaging, providing quantitative assessment of tissue stiffness and offering valuable diagnostic insights across a wide spectrum of diseases. Unlike conventional ultrasound, which primarily evaluates morphological changes, SWE enables early detection of biomechanical alterations associated with malignancy and fibrosis. This review highlights the principles, techniques, and clinical applications of SWE in oncology, with a focus on liver, kidney, breast, thyroid, and prostate cancers. SWE demonstrates high accuracy in staging liver fibrosis, characterizing breast lesions, and enhancing the detection of clinically significant prostate cancers, while also showing promise in renal and thyroid evaluations. Despite its clinical utility, several limitations persist, including operator dependency, variability across elastography systems, and technical challenges related to tissue heterogeneity and motion artifacts. Nevertheless, SWE continues to evolve as a complementary tool that improves diagnostic confidence, reduces unnecessary invasive procedures, and enhances treatment monitoring. Ongoing refinements in technology and standardization of protocols are expected to further expand its role in cancer diagnosis and management.