Shear wave elasticity imaging of cervical lymph nodes

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Elastography

Background:

• Cervical lymphadenopathy evaluation often involves conventional ultrasound (US) and fine-needle aspiration.
• Real-time shear wave ultrasound elastography (SWE) offers a non-invasive method to assess tissue stiffness.

Purpose of the Study:

• To evaluate the feasibility and diagnostic performance of real-time SWE for cervical lymphadenopathy in routine clinical practice.
• To correlate elastographic measurements with cytological findings.

Main Methods:

• A pilot study involving 55 cervical lymph nodes assessed with conventional US and SWE.
• Measurement of elastic moduli in the stiffest regions of lymph nodes.
• Correlation of elastography data with results from US-guided needle aspiration for cytology.

Main Results:

• Malignant nodes (n=31) were significantly stiffer (median 25.0 kPa) than benign nodes (n=24, median 21.4 kPa) (p=0.008).
• A stiffness cut-off of 30.2 kPa yielded 61.8% accuracy, 41.9% sensitivity, and 100% specificity.
• Elastograms showed benign nodes as homogeneously soft, while malignant nodes varied from homogeneously soft to markedly heterogeneous.

Conclusions:

• SWE is feasible for assessing cervical lymph nodes.
• SWE may not be suitable for general cancer screening but could aid in detecting a subset of malignant nodes.
• The heterogeneity observed in malignant nodes on SWE requires further investigation.