Shear Wave Elastography for Distinguishing Cervical Lymph Node Malignancy: A Prospective, Observational Study

Area of Science:

• Medical Imaging
• Oncology
• Ultrasound Technology

Background:

• Distinguishing benign from malignant cervical lymph nodes is clinically significant.
• Cervical lymphadenopathy can result from lymphomas or solid tumor metastases.
• Accurate preoperative nodal staging is crucial for treatment planning.

Purpose of the Study:

• To evaluate the efficacy of shear wave elastography (SWE) in differentiating lymphomas and solid tumor metastases in cervical lymph nodes.
• To assess the quantitative stiffness measurements provided by SWE for nodal characterization.

Main Methods:

• Prospective, observational, single-center study involving adults with suspicious cervical lymph nodes.
• Conventional ultrasound and shear wave elastography (SWE) with quantitative stiffness assessment (kPa).
• Pathology examination served as the gold standard for confirmation; statistical analysis included logistic regression.

Main Results:

• Maximum shear wave velocity (SWV) was lower in benign pathologies (35 kPa) compared to lymphoma (40 kPa) and metastases (50 kPa).
• Higher prevalence of squamous cell carcinoma and distant metastases observed in men.
• Each 1 kPa increase in SWE measurement correlated with a 3% rise in the risk of metastatic adenopathy.

Conclusions:

• Shear wave elastography (SWE) demonstrates significant potential for the preoperative assessment of nodal status.
• SWE can aid in distinguishing between benign and malignant cervical lymph nodes.
• This technique is valuable for managing malignancies affecting the head and neck, thyroid, and other regions.