title: Noninvasive Evaluation of Benign and Malignant Superficial Lymph Nodes by Virtual Touch Tissue Quantification: A Pilot Study.
abstract: OBJECTIVE
  The purpose of this study was to investigate the value of Virtual Touch tissue quantification (Siemens Medical Solutions, Erlangen, Germany) for differentiation of benign and malignant superficial lymph node lesions.
  
  
  METHODS
  Shear wave velocity (SWV) values were analyzed in 113 patients, who also had diagnoses by pathologic examination. The diagnostic performance of the SWV was evaluated by sensitivity and specificity at the optimum cutoff value and the area under the receiver operating characteristic curve (AUROC).
  
  
  RESULTS
  A total of 60 benign lesions (32 reactive hyperplasia and 28 tuberculosis) and 53 malignant lesions (27 lymphomas and 26 metastatic carcinomas) were studied. The SWV was significantly different between benign (mean ± SD, 3.137 ± 0.857 m/s) and malignant (7.042 ± 1.427 m/s) lesions (P< .001) and yielded sensitivity of 92.5% (95% confidence interval [CI], 81.8%-97.9%) and specificity of 96.7% (95% CI, 88.5%-99.6%) at an optimum cutoff value of 4.645 m/s. The AUROC was 0.973 (95% CI, 0.924-0.994). To separate reactive hyperplasia from tuberculosis within benign lesions, a cutoff value of 2.978 m/s provided sensitivity of 92.9% (95% CI, 76.5%-99.1%) and a specificity of 100% (95% CI, 89.1%-100%), with an AUROC of 0.989 (95% CI, 0.920-1.000). To separate lymphoma from metastatic carcinoma within malignant lesions, a cutoff value of 7.302 m/s provided sensitivity of 88.5% (95% CI, 69.8%-97.6%) and specificity of 81.5% (95% CI, 61.9%-93.7%), with an AUROC of 0.906 (95% CI, 0.764-0.969).
  
  
  CONCLUSIONS
  Virtual Touch tissue quantification provides a promising noninvasive strategy for differentiation of benign and malignant superficial lymph node lesions.
authors.affiliation: Department of Ultrasound, First Affiliated Hospital of Shantou University Medical College, Shantou, China.
authors.forename: Shaoqi
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Ultrasound, First Affiliated Hospital of Shantou University Medical College, Shantou, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Lin
authors.affiliation: Department of Ultrasound, First Affiliated Hospital of Shantou University Medical College, Shantou, China.
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Ultrasound, First Affiliated Hospital of Shantou University Medical College, Shantou, China. 1036587183@qq.com.
authors.forename: Baoqun
authors.initials: B
authors.lastname: Zheng
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging; D014584:User-Computer Interface
keywords: Virtual Touch tissue quantification; differentiation; superficial lymph node lesion