Ultrasonography and sonoelastography in cervical lymph node differentiation: A cross-sectional study

Cervical lymphadenopathy poses a diagnostic challenge, particularly in distinguishing benign from malignant lymph nodes non-invasively. Therefore, it is of interest to evaluate the diagnostic utility of B-mode ultrasonography, color Doppler, strain elastography and shear wave elastography in 100 patients at a tertiary center in East India. Histopathology served as the reference standard to determine sensitivity, specificity and AUC for each modality. Shear wave elastography, especially perinodal rim stiffness, showed the highest individual accuracy, while the combined B-mode-Doppler-SWE approach demonstrated 94% overall accuracy. Thus, we show that integrating shear wave elastography with conventional ultrasonography significantly enhances differentiation of benign and malignant cervical lymph nodes.