title: Real-time ultrasound elastography: an assessment of enlarged cervical lymph nodes.
abstract: OBJECTIVE
  To determine the efficacy of real-time elastography (RTE), compared with our previously proposed prediction model, in the detection of malignancy in cervical lymph nodes (LNs).
  
  
  METHODS
  One hundred and thirty-one patients underwent ultrasound-guided fine needle aspiration biopsy (ultrasound FNAB) after ultrasound and RTE evaluation. The formula of the RTE scoring system was a four-point visual scale, based on a previously determined model. The formula of the prediction model was: [Formula: see text]. An extended model was constructed with four previous predictors and elasticity scores, using a logistic regression model.
  
  
  RESULTS
  Final histology revealed 77 benign and 54 malignant LNs. In the elasticity score system, sensitivity was 66.7 %, specificity was 57.1 %, the positive predictive value (PPV) was 52.2 % and the negative predictive value (NPV) was 71.0 %. In the prediction model system, sensitivity was 79.6 %, specificity was 92.2 %, the PPV was 87.8 % and the NPV was 86.6 %. When the extended and the original model were compared, the areas under the receiver operating characteristic curve (c-statistic) was 0.94 and 0.95, respectively (P > 0.05).
  
  
  CONCLUSIONS
  Qualitative RTE offers no additional value over conventional ultrasound in predicting malignancy in cervical LNs.
  
  
  CONCLUSIONS
  • An ultrasound system can help in the assessment of cervical lymph nodes. • Grey-scale and power Doppler ultrasound remain fundamental for neck nodal evaluation. • Qualitative real-time elastography provided no additional value compared with current prediction models.
authors: Department of Otolaryngology, Far Eastern Memorial Hospital, No. 21, Section 2, Nan-Ya South Road, Banqiao, New Taipei, Taiwan, 220.
authors: Wu-Chia
authors: WC
authors: Lo
authors: Po-Wen
authors: PW
authors: Cheng
authors: Chi-Te
authors: CT
authors: Wang
authors: Li-Jen
authors: LJ
authors: Liao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging*; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D015588:Observer Variation; D011237:Predictive Value of Tests; D011897:Random Allocation; D012044:Regression Analysis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*; D055815:Young Adult
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