Contribution of elastography in diagnostics of malignant cervical lymph nodes

Congress:

ECR 2019

Poster Number:

C-0384

Type:

Scientific Exhibit

Keywords:

Head and neck, Lymph nodes, Elastography, Ultrasound, Ultrasound-Colour Doppler, Biopsy, Cancer, Lymphoma, Metastases

Authors:

Z. Sedlackova, M. Herman, T. Fürst, J. Herman, R. Salzman; Olomouc/CZ

DOI:

10.26044/ecr2019/C-0384

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-0384

Fig. 1: Fig. 1. Patient with papillary carcinoma, panoramic view of three enlarged...

Fig. 2: Fig. 2. Patient with squamous cell carcinoma, shear wave elastography of...

Fig. 3: Fig. 3. Maximum stiffness is significantly different among the various...

Fig. 4: Fig. 4. Patient with lymphoma, shear wave elastography. Lymph nodes with soft...

Fig. 5: Fig. 5. ROC curves for the three predictive models. The blue line predicts...

Aims and objectives

Elastography is an ultrasonographic method evaluating tissue stiffness. Compared to strain elastography, shear wave elastography (SWE) offers the advantage of quantitative measurements, lower operator-dependence and shows a relatively narrow range of normal tissue values. Our aim was to determine ultrasound parameters significant for differentiation between benign and malignant cervical lymph nodes, with special attention paid to shear wave elastographic measurements.

Methods and materials

This prospective observational study was approved by institutional ethics committee and written informed consent was obtained from all participants. All patients with a neck mass were referred for ultrasound examination including elastography after thorough clinical examination; 84 of them underwent a biopsy and 15 patients with benign-appearing lymph nodes were followed up for two years. Remaining patients with clearly benign lymph nodes with no follow up, or patients with other neck pathology, were excluded from the study group, resulting in total of 99 study subjects....

Results

Total of 43 benign and 56 malignant lymph nodes were included in the study. Benign group included reactive lymphadenitis, tuberculosis and sarcoidosis lymph nodes, the remaining lymph nodes were regarded as malignant and were divided into the following subgroups: squamous cell carcinoma metastases, thyroid carcinoma metastases, lymphomas and other metastases. Table 1 summarises all statistically significant parameters for predicting malignancy. Concerning demographic factors, male gender and higher age were significant predictors, the median age of patients with malignant lymph nodes was 62 years compared to...

Conclusion

Using the information from shear wave elastography seems to bring slightly more power in differentiating between benign and malignant lymph node findings.

Personal information

References

Bhatia KS, Lee YY, Yuen EH, Ahuja AT. Ultrasound elastography in the head and neck. Part I. basic principles and practical aspects. Cancer Imaging. 2013; 13.2:253–259. Bhatia KS, Cho CC, Tong CS, Yuen EH, Ahuja AT. Shear wave elasticity imaging of cervical lymph nodes. Ultrasound Med Biol. 2012; 38:195–201. Choi YJ, Lee JH, Lim HK et al. Quantitative shear wave elastography in the evaluation of metastatic cervical lymph nodes. Ultrasound Med Biol. 2013; 39:935–940. Desmots F, Fakhry N, Mancini J et al. Shear wave elastography...