title: Shear wave elasticity imaging of cervical lymph nodes.
abstract: A pilot study of real-time shear wave ultrasound elastography (SWE) for cervical lymphadenopathy in routine clinical practice was conducted on 55 nodes undergoing conventional ultrasound (US) with US-guided needle aspiration for cytology. Elastic moduli of stiffest regions in nodes were measured on colour-coded elastograms, which were correlated with cytology. Malignant nodes (n = 31, 56.4%) were stiffer (median 25.0 kPa, range 6.9-278.9 kPa) than benign nodes (median 21.4 kPa, range 8.9-30.2 kPa) (p = 0.008, Mann Whitney U test). A cut-off of 30.2 kPa attained highest accuracy of 61.8%, corresponding to 41.9% sensitivity, 100% specificity and 0.77 area under the receiver operating characteristic curve. Qualitatively, elastograms of benign nodes were homogeneously soft; malignant nodes were homogeneously soft or markedly heterogeneous with some including regions lacking elasticity signal. SWE is feasible for neck nodes. It appears unsuitable for cancer screening but may detect a subset of malignant nodes. The cause of spatial heterogeneity of malignant nodes on SWE is yet to be established.
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China.
authors.forename: Kunwar S S
authors.initials: KS
authors.lastname: Bhatia
authors.forename: Carmen C M
authors.initials: CC
authors.lastname: Cho
authors.forename: Cina S L
authors.initials: CS
authors.lastname: Tong
authors.forename: Edmund H Y
authors.initials: EH
authors.lastname: Yuen
authors.forename: Anil T
authors.initials: AT
authors.lastname: Ahuja
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D033081:Shear Strength; D055815:Young Adult