Acoustic radiation force impulse imaging for reactive and malignant/metastatic cervical lymph nodes

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Oncology

Background:

• Cervical lymph node swelling necessitates accurate differentiation between reactive and metastatic causes.
• Distinguishing benign reactive nodes from malignant metastatic nodes is crucial for patient management.

Purpose of the Study:

• To compare lymph node stiffness using Acoustic Radiation Force Impulse (ARFI) imaging in patients with cervical lymph node swelling.
• To evaluate the efficacy of ARFI imaging in differentiating reactive from metastatic cervical lymph nodes.

Main Methods:

• Forty-two cervical lymph nodes (22 reactive, 20 metastatic) from 19 patients were assessed using ARFI imaging.
• Shear wave velocity (SWV) was measured for each lymph node.
• Receiver operating characteristic (ROC) curve analysis was performed to determine diagnostic accuracy.

Main Results:

• The mean SWV for reactive lymph nodes was 1.52 ± 0.48 m/s.
• The mean SWV for metastatic/malignant lymph nodes was 2.46 ± 0.75 m/s.
• A SWV threshold > 1.9 m/s achieved 95.0% specificity, 81.8% sensitivity, and 88.0% overall accuracy for metastatic node classification (AUC = 0.923).

Conclusions:

• ARFI imaging is a valuable tool for differentiating reactive and malignant/metastatic cervical lymph nodes.
• SWV measurements obtained via ARFI imaging provide objective data on lymph node stiffness.
• This technique can aid in clinical decision-making for patients with cervical lymphadenopathy.