Shear Wave Elastography as a Supplement Tool in Differentiating Benign and Malignant Axillary Lymph Nodes

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Oncology

Background:

• Axillary lymph node (ALN) assessment is crucial for cancer staging.
• Differentiating benign from malignant ALN can be challenging with conventional B-mode sonography.

Purpose of the Study:

• To evaluate the diagnostic performance of quantitative shear wave elastography (SWE) in distinguishing between benign and malignant axillary lymph nodes.
• To correlate tissue elasticity measurements with histopathological findings.

Main Methods:

• 127 patients with palpable axillary swelling underwent B-mode sonography and SWE.
• ALN were assessed for size, shape, hilum, cortical thickness, and border.
• Shear wave elastography measured mean elasticity modulus (E-mean) and elasticity ratio (E-ratio).
• Histopathology or fine needle aspiration cytology served as the gold standard.

Main Results:

• Malignant ALN exhibited significantly higher E-mean (73.15 kPa) and E-ratio (10.2) compared to benign ALN (21.47 kPa and 2.95, respectively).
• The area under the receiver operating characteristic curve for E-ratio was 0.816, indicating good diagnostic accuracy.
• A significant association was found between tissue elasticity and pathological correlation.

Conclusions:

• Quantitative shear wave elastography is an effective tool for differentiating benign and malignant axillary lymph nodes.
• Tissue elasticity measurements correlate significantly with pathological diagnoses, offering a valuable non-invasive diagnostic approach.