Modified sonoelastographic scale score for lymph node assessment in lymphoma - a preliminary report

Area of Science:

• Medical Imaging
• Oncology
• Diagnostic Techniques

Background:

• Elastography is an emerging technique for evaluating lymph node stiffness.
• Research has primarily focused on its use in detecting metastases from head and neck or breast cancers.
• Lymphomas less frequently exhibit the desmoplastic reaction common in other cancers, impacting tissue hardening.

Purpose of the Study:

• To investigate the utility of sonoelastography in assessing lymph node consistency in patients with lymphoma.
• To correlate elastographic findings with conventional ultrasonographic features in lymphoma and reactive lymphadenopathy.

Main Methods:

• A study involving 15 patients with active Hodgkin and non-Hodgkin lymphomas and 16 patients with no evidence of recurrence after treatment.
• A control group of 60 patients with reactive lymphadenopathy.
• Analysis of lymph node size, appearance, vascularity, and elastogram (Type B or C).

Main Results:

• A Type C elastogram strongly correlated with lymph nodes exhibiting at least three pathological features on 2D imaging.
• Large lymph nodes (>3 cm) with active lymphoma could present a "cheese with holes" appearance, analogous to Type C but sonographically mapped as Type B.
• Type C elastograms were observed in patients with active lymphoma and in some cases of reactive lymphadenopathy.

Conclusions:

• A simplified sonoelastography scoring system suggests Type C elastograms are primarily associated with active lymphoma when lymph nodes display all four analyzed conventional ultrasonographic features.
• The "cheese with holes" appearance in large lymphoma nodes is equivalent to a Type C elastogram, despite its Type B sonographic mapping.
• Sonoelastography shows potential in differentiating active lymphoma from other lymph node conditions.