The Role of Ultrasound and Shear-Wave Elastography in Evaluation of Cervical Lymph Nodes

Aim. To evaluate the prognostic value of ultrasound and shear-wave elastography (SWE) in diagnosing malignant cervical lymph nodes. Methods. A total of 99 patients with enlarged lymph nodes (99 lymph nodes presenting as a neck mass) were examined clinically with conventional ultrasound including Doppler examination and shear-wave elastography. The results of the examinations were compared with the final diagnosis. Results. There were 43 benign and 56 malignant lymph nodes in our cohort. Age and sex were significant predictors of malignancy. The standard ultrasound parameters—node size, long/short axis ratio, hilum, vascularization, and the presence of microcalcifications—were also statistically significant. Lymph node volume combined with age showed the best predictive power. The maximum stiffness found on SWE was also a significant predictor of malignancy. The combination of epidemiologic, classic ultrasound, and elastographic parameters yielded the highest sensitivity and specificity in the prediction of malignancy; however, the additional impact of elastographic parameters was low. Conclusion. A combination of epidemiologic and classic ultrasound parameters can discriminate between malignant and benign lymph nodes with satisfactory sensitivity and specificity. Examining the stiffness of lymph nodes by means of SWE does not add much new predictive power.

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Shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20180454 ◽

2019 ◽

Vol 48 (6) ◽

pp. 20180454 ◽

Cited By ~ 2

Author(s):

Yoshihiko Sasaki ◽

Ichiro Ogura

Keyword(s):

Elastic Modulus ◽

Lymph Nodes ◽

Shear Wave ◽

Rank Correlation ◽

Shear Wave Elastography ◽

Oral Carcinoma ◽

Cervical Lymph Nodes ◽

Significance Level ◽

Axial Diameter ◽

Shear Elastic Modulus

Objectives: To evaluate shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma. Methods: 77 patients with oral squamous cell carcinoma were examined by B-mode and shear wave elastography with a 14 MHz linear transducer. The integrated shear wave elastography software allowed the operator to place regions of interest of various sizes within the elastography window, and automatically displayed shear elastic modulus data (kPa) for each region of interest. The relationship between size and shear elastic modulus of cervical lymph nodes was assessed by Pearson's rank correlation test. The shear elastic modulus of cervical lymph nodes in benign and malignant were evaluated using the Mann–Whitney U test. The analyses were used with a 5% significance level. Results: We plotted shear elastic modulus (X) against minimal axial diameter of cervical lymph nodes (Y), and observed a significant correlation [ Y = 0.091 X + 4.648 (R2 = 0.603, p = 0.000, N = 77)]. Furthermore, the shear elastic modulus of the malignant cervical lymph nodes (105.9 ± 5.2 kPa) was higher than that of benign (11.9 ± 4.4 kPa, p = 0.000). Conclusions: The shear wave elastography is an effective technique for the objectively and quantitatively diagnosis of cervical lymph node metastases of the oral carcinoma.

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