title: Differentiation of metastatic cervical lymph nodes with ultrasound elastography by virtual touch tissue imaging: preliminary study.
abstract: OBJECTIVE
  The purpose of this study was to investigate the clinical usefulness of acoustic radiation force impulse elastography for the differential diagnosis of cervical lymph nodes.
  
  
  METHODS
  Virtual touch tissue imaging (Siemens Medical Solutions, Mountain View, CA) was analyzed in 81 patients (mean age, 46.6 years; range, 5-82 years) with 81 lymph nodes (45 metastatic nodes and 36 benign nodes).
  
  
  RESULTS
  Most benign lymph nodes were slightly darker or the same in brightness compared with surrounding tissue, whereas most metastatic nodes were obviously darker. The mean area ratio of benign lymph nodes ± SD (1.05 ± 0.15) was statistically lower than the mean area ratio of metastatic lymph nodes (1.39 ± 0.20; P < 0.001). The area ration cutoff level for metastatic lymph nodes was estimated to be 1.16. With the use of a receiver operating characteristic curve with this cutoff value, the area ratio predicted malignancy with sensitivity of 91.1%, specificity of 83.3%, and an area under the curve of 0.925.
  
  
  CONCLUSIONS
  Acoustic radiation force impulse imaging is feasible for cervical lymph nodes. The Virtual Touch tissue imaging technique can complement conventional sonography, thereby making it easier to diagnose cervical lymph nodes.
authors.affiliation: From the Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China (D.C., X.Z., M.-L.S., X.W., Z.J.); and Ultrasound Department, First Affiliated Hospital of Harbin Medical University, Harbin, China (C.W.).
authors.forename: Dehong
authors.initials: D
authors.lastname: Che
authors.affiliation: From the Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China (D.C., X.Z., M.-L.S., X.W., Z.J.); and Ultrasound Department, First Affiliated Hospital of Harbin Medical University, Harbin, China (C.W.).
authors.forename: Xianli
authors.initials: X
authors.lastname: Zhou
authors.affiliation: From the Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China (D.C., X.Z., M.-L.S., X.W., Z.J.); and Ultrasound Department, First Affiliated Hospital of Harbin Medical University, Harbin, China (C.W.).
authors.forename: Mei-Ling
authors.initials: ML
authors.lastname: Sun
authors.affiliation: From the Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China (D.C., X.Z., M.-L.S., X.W., Z.J.); and Ultrasound Department, First Affiliated Hospital of Harbin Medical University, Harbin, China (C.W.).
authors.forename: Xiao
authors.initials: X
authors.lastname: Wang
authors.affiliation: From the Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China (D.C., X.Z., M.-L.S., X.W., Z.J.); and Ultrasound Department, First Affiliated Hospital of Harbin Medical University, Harbin, China (C.W.).
authors.forename: Zhaopeng
authors.initials: Z
authors.lastname: Jiang
authors.affiliation: From the Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China (D.C., X.Z., M.-L.S., X.W., Z.J.); and Ultrasound Department, First Affiliated Hospital of Harbin Medical University, Harbin, China (C.W.). cjwcdh@163.com.
authors.lastname: Changjun-Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D010865:Pilot Projects; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014584:User-Computer Interface; D055815:Young Adult
keywords: acoustic radiation force impulse; cervical lymph nodes; head and neck ultrasound; sonography