Diagnostic Value of Shear Wave Elastography in Differentiation between Benign from Malignant Cervical Lymph Nodes

Mohammadreza Chavoshi; Milad Taghavi; Hassan Hashemi; Mohammad Davoodi; Pouria Rouzrokh; Leila Aghaghazvini

doi:10.18502/jimc.v6i4.13446

Mohammadreza Chavoshi Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Milad Taghavi Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Hassan Hashemi Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Davoodi Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Pouria Rouzrokh Evidence based medicine research center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Tehran, Iran
Leila Aghaghazvini Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v6i4.13446

Keywords: Cervical, Lymph node, Malignant, Shear wave elasto-graphy, Ultrasound

Abstract

Background: This study aims to evaluate the role of Shear Wave Elastography (SWE) in the differentiation of malignant from benign cervical lymph nodes and compare its accuracy with conventional ultrasound.

Methods: Seventy-one lymph nodes (malignant=52, benign=19) were investigated by both conventional sonography and SWE. Shear Wave Velocity (SWV) and color map were obtained for each lymph node before tissue sampling. R statistical software (x64, v3.6.1) was used for statistical analysis.

Results: Among all the conventional and elastography features, color map grading and shear wave velocity (SWV) had the most correlation with malignancy, even in normal-sized nodes. SWV was significantly correlated with the pathology (rpb=0.62, p<0.00). The best cutoff-value for SWV was 2.71 m/s (sensitivity: 82.7%, specificity:84.2%, AUC=0.92). The best predicting model by multivariate analysis was obtained by a combination of SWV and color map grading (sensitivity=92.3%, specificity=94.7%).

Conclusion: SWE is a valuable method for the differentiation of malignant from benign lymph nodes. It would help to find the proper lymph node for biopsy.