title: Preliminary Evaluation of Virtual Touch Tissue Imaging Quantification for Differential Diagnosis of Metastatic and Nonmetastatic Cervical Lymph Nodes.
abstract: OBJECTIVE
  Virtual Touch tissue imaging quantification (VTIQ; Siemens Medical Solutions, Mountain View, CA) is useful for assessing tissue hardness. This study aimed to investigate the value of VTIQ in differential diagnosis of cervical lymph nodes.
  
  
  METHODS
  We retrospectively analyzed conventional sonograms and VTIQ images of 85 pathologically confirmed patients with superficial lymph node lesions. Conventional sonography was first performed, with 2-dimensional images described. Then VTIQ shear wave velocity (SWV) values of superficial lymph nodes were measured. With pathologic diagnosis as the reference standard, a receiver operating characteristic curve was generated to evaluate VTIQ efficacy in differential diagnosis of metastatic and nonmetastatic cervical lymph nodes.
  
  
  RESULTS
  Of the 85 nodes, 44 and 41 were metastatic and nonmetastatic, respectively. The latter group included 24 and 17 hematologic/lymphatic system disease and reactive hyperplastic nodes, respectively. Shear wave velocity values of metastatic nodes were significantly higher than those of their nonmetastatic counterparts (P < .001). With an area under the curve (AUC) of 0.953 and SWV cutoff of 3.27 m/s, accuracy, sensitivity, and specificity were 89.4%, 88.6%, and 90.2%, respectively, for distinguishing metastatic and nonmetastatic nodes. An AUC of 0.943 and SWV cutoff of 3.23 m/s yielded accuracy, sensitivity, and specificity of 88.2%, 88.6%, and 87.5% for differentiating metastatic from hematologic/lymphatic system disease nodes. Finally, an AUC of 0.968 and SWV cutoff of 3.27 m/s yielded accuracy, sensitivity, and specificity of 90.2%, 88.6%, and 94.1% for differentiating metastatic from reactive hyperplastic nodes.
  
  
  CONCLUSIONS
  Virtual Touch tissue imaging quantification is efficient in differential diagnosis of metastatic and nonmetastatic cervical lymph nodes.
authors.affiliation: Department of Ultrasonography, Changhai Hospital, affiliated with the Second Military Medical University, Shanghai, China.
authors.forename: Yingyan
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Ultrasonography, Changhai Hospital, affiliated with the Second Military Medical University, Shanghai, China.
authors.forename: Jiaying
authors.initials: J
authors.lastname: Xi
authors.affiliation: Department of Ultrasonography, Changhai Hospital, affiliated with the Second Military Medical University, Shanghai, China.
authors.forename: Baozhen
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Department of Ultrasonography, Changhai Hospital, affiliated with the Second Military Medical University, Shanghai, China.
authors.forename: Wenfeng
authors.initials: W
authors.lastname: Xiong
authors.affiliation: Department of Ultrasonography, Changhai Hospital, affiliated with the Second Military Medical University, Shanghai, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Jiang
authors.affiliation: Department of Ultrasonography, Changhai Hospital, affiliated with the Second Military Medical University, Shanghai, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Ultrasonography, Changhai Hospital, affiliated with the Second Military Medical University, Shanghai, China.
authors.forename: Zhuhong
authors.initials: Z
authors.lastname: Cai
authors.affiliation: Department of Ultrasonography, Changhai Hospital, affiliated with the Second Military Medical University, Shanghai, China.
authors.forename: Tianjia
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Ultrasonography, Changhai Hospital, affiliated with the Second Military Medical University, Shanghai, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Nephrology, First People's Hospital, Shanghai General Hospital, affiliated with Shanghai Jiaotong University, Shanghai, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Rong
authors.affiliation: Department of Ultrasonography, Changhai Hospital, affiliated with the Second Military Medical University, Shanghai, China.
authors.forename: Xiucai
authors.initials: X
authors.lastname: Jin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D014584:User-Computer Interface
keywords: Virtual Touch tissue imaging quantification; cervical lymph nodes; head and neck ultrasound; shear wave elastography; sonography