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Visualizing Lymph Node Structure and Cellular Localization using Ex-Vivo Confocal Microscopy
Published on: August 9, 2019
Noninvasive Evaluation of Benign and Malignant Superficial Lymph Nodes by Virtual Touch Tissue Quantification: A
Shaoqi Chen1, Xiaoming Lin1, Xiaoxia Chen1
1Department of Ultrasound, First Affiliated Hospital of Shantou University Medical College, Shantou, China.
Objectives:
The purpose of this study was to investigate the value of Virtual Touch tissue quantification (Siemens Medical Solutions, Erlangen, Germany) for differentiation of benign and malignant superficial lymph node lesions.
Methods:
Shear wave velocity (SWV) values were analyzed in 113 patients, who also had diagnoses by pathologic examination. The diagnostic performance of the SWV was evaluated by sensitivity and specificity at the optimum cutoff value and the area under the receiver operating characteristic curve (AUROC).
Results:
A total of 60 benign lesions (32 reactive hyperplasia and 28 tuberculosis) and 53 malignant lesions (27 lymphomas and 26 metastatic carcinomas) were studied. The SWV was significantly different between benign (mean ± SD, 3.137 ± 0.857 m/s) and malignant (7.042 ± 1.427 m/s) lesions (P< .001) and yielded sensitivity of 92.5% (95% confidence interval [CI], 81.8%-97.9%) and specificity of 96.7% (95% CI, 88.5%-99.6%) at an optimum cutoff value of 4.645 m/s. The AUROC was 0.973 (95% CI, 0.924-0.994). To separate reactive hyperplasia from tuberculosis within benign lesions, a cutoff value of 2.978 m/s provided sensitivity of 92.9% (95% CI, 76.5%-99.1%) and a specificity of 100% (95% CI, 89.1%-100%), with an AUROC of 0.989 (95% CI, 0.920-1.000). To separate lymphoma from metastatic carcinoma within malignant lesions, a cutoff value of 7.302 m/s provided sensitivity of 88.5% (95% CI, 69.8%-97.6%) and specificity of 81.5% (95% CI, 61.9%-93.7%), with an AUROC of 0.906 (95% CI, 0.764-0.969).
Conclusions:
Virtual Touch tissue quantification provides a promising noninvasive strategy for differentiation of benign and malignant superficial lymph node lesions.

