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Shear Wave Elastography as a Supplement Tool in Differentiating Benign and Malignant Axillary Lymph Nodes
Aishwarya Sharma1, Ravinder Kaur1, Narinder Kaur1
1Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India.
Objectives:
To determine the efficacy of quantitative shear wave elastography in differentiating benign and malignant axillary lymph nodes (ALN).
Methods:
Exactly 127 lymph nodes from 127 patients with clinically palpable axillary swelling were examined by both B-mode sonography and elastography from November 2022 to March 2024. Gray-scale sonograms were evaluated based on: the short-axis diameter, shape, hilum, maximum cortical thickness, and border of the ALN. Shear wave elastography determined the mean elasticity modulus (E-mean) and elasticity ratio (E-ratio). Fine needle aspiration cytology or histopathological examination was kept as the gold standard and diagnostic performance shear wave elastography was compared.
Results:
The data showed that out of 127 lymph nodes, 77 (60.6%) were benign and 50 (39.4%) were malignant based on pathological results. The E-mean for malignant lymph nodes (mean, 73.15 kPa) was higher than that for benign lymph nodes (mean, 21.47 kPa; P < .001). The area under the receiver operating characteristic curve for E-ratio in predicting malignant and benign lymph nodes was 0.897 (95% CI: 0.839-0.955). The E-ratio for malignant lymph nodes was also higher (mean, 10.2) than for benign nodes (mean, 2.95; P < .001). The area under the receiver operating characteristic curve for E-ratio in predicting malignant and benign lymph nodes was 0.816 (95% CI: 0.733-0.899).
Conclusion:
Our results showed a significant association between tissue elasticity and pathological correlation.
