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Shear Wave Elastography and Cervical Lymph Nodes: Predicting Malignancy.

Ghobad Azizi1, James M Keller2, Michelle L Mayo1

  • 1Wilmington Endocrinology, Wilmington, North Carolina, USA.

Ultrasound in Medicine & Biology
|March 16, 2016
PubMed
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Virtual Touch Imaging Quantification (VTIQ) accurately measures cervical lymph node stiffness using shear wave elastography. This non-invasive method helps differentiate benign from malignant lymph nodes, improving diagnostic accuracy.

Area of Science:

  • Medical Imaging
  • Oncology
  • Diagnostic Ultrasound

Background:

  • Cervical lymph node evaluation is crucial for cancer staging and management.
  • Distinguishing benign from malignant lymph nodes non-invasively remains a clinical challenge.
  • Shear wave elastography offers a quantitative method to assess tissue stiffness.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of Virtual Touch Imaging Quantification (VTIQ) for cervical lymph node stiffness.
  • To determine the effectiveness of VTIQ in differentiating benign from malignant cervical lymph nodes.
  • To establish a shear wave velocity (SWV) cut-off value for malignancy prediction.

Main Methods:

  • Prospective study involving 236 patients and 270 cervical lymph nodes.
Keywords:
Fine-needle aspiration biopsyLymph nodeMalignancyShear wave elastographyUltrasound

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  • Conventional B-mode ultrasound and VTIQ shear wave elastography were performed prior to fine-needle aspiration biopsy (FNAB).
  • LN stiffness measured as shear wave velocity (SWV) in m/s; surgical pathology confirmed malignancy in 54 LNs.

    • Main Results:

    • A cut-off SWV of 2.93 m/s was identified as the maximum value for predicting malignant cervical lymph nodes.
    • VTIQ demonstrated a sensitivity of 92.59% and specificity of 75.46% for malignancy.
    • Negative predictive value (NPV) was high at 97.60%, while positive predictive value (PPV) was 48.54%.

    Conclusions:

    • LN stiffness measured by VTIQ-generated shear wave elastography is a valuable, independent predictor of cervical lymph node malignancy.
    • VTIQ provides a non-invasive tool to aid in the characterization of cervical lymph nodes.
    • The established SWV cut-off value can assist clinicians in risk stratification and treatment decisions.