The value of shear wave elastography in predicting for undiagnosed small cervical lymph node metastasis in nasopharyngeal carcinoma: A preliminary study

Chen, Binbin; Li, Jian; Guan, Ying; Xiao, Weiwei; Zhao, Chong; Lu, Tai‐Xiang; Han, Fei

doi:10.1016/j.ejrad.2018.03.006

Cited by 22 publications

(41 citation statements)

References 33 publications

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“…Xu et al[23] revealed the accuracy of acoustic radiation force impulse in predicting cervical lymph node metastasis. However, the value of elastography in the diagnosis of cervical lymph node metastasis was limited[28]. In the present study, the elasticity of metastatic lymph nodes was harder.…”

Section: Discussionmentioning

confidence: 60%

Value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in papillary thyroid carcinoma

Jiang¹,

H²,

Zhang³

et al. 2019

WJCC

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BACKGROUNDCervical lymph node metastasis in papillary thyroid carcinoma (PTC) affects the treatment and prognosis of patients. Ultrasound is a common imaging method for detecting cervical lymph nodes in PTC patients; however, it is not accurate in determining lymph node metastasis.AIMTo evaluate the value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in PTC.METHODSA total of 94 patients with PTC were recruited. According to pathological results, lymph nodes were divided into two groups: metastatic group (n = 50) and reactive group (n = 63). The routine ultrasound findings, contrast-enhanced ultrasound and elastography data were recorded and compared. Logistic regression was used to generate predictive probability distributions for the diagnosis of lymph node metastasis with different indicators. Receiver operating characteristic curve analysis was used to test the efficacy of contrast-enhanced ultrasound combined with elastography based on routine ultrasound in evaluating PTC cervical lymph node metastasis.RESULTSThe ratio of long diameter/short diameter (L/S) ≤ 2, irregular marginal morphology, missing lymphatic portal, peripheral or mixed blood flow distribution, peak intensity (PI), non-uniform contrast distribution and elasticity score in the metastatic group were significantly higher than those in the reactive group (P < 0.05). L/S ratio, missing lymphatic portal, PI and elasticity score had a significant influence on the occurrence of PTC cervical lymph node metastasis (P < 0.05). Furthermore, the area under the curve (AUC) for lymph node metastasis diagnosed using the combination of PI ratio, elasticity score, missing lymphatic portal and LS was 0.936, which was significantly higher than the AUC for PI ratio alone. The difference was statistically significant (P < 0.05). The fitting equation for the combined diagnosis was logit(P) = -12.341 + 1.482 × L/S ratio + 3.529 × missing lymphatic portal + 0.392 × PI + 3.288 × elasticity score.CONCLUSIONBased on the gray-scale ultrasound, the combination of contrast-enhanced ultrasound and elastography can accurately assess PTC cervical lymph node metastasis.

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Section: Discussionmentioning

confidence: 60%

Value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in papillary thyroid carcinoma

Jiang¹,

H²,

Zhang³

et al. 2019

WJCC

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“…In a meta-analysis of eight studies, malignant nodes are stiffer (higher elasticity and higher speed) than benign nodes and the final results of the studies conclude that SWE for diagnosing malignant cervical LN had a summary sensitivity of 81% and a specificity of 85%, and the area under the curve was 0.88 22 . In subsequent studies of SWE, regarding a relatively large number of patients 12 , metastasis from nasopharyngeal carcinoma 23 and lymphoma in pediatric patients 24 , consistently show more stiffness of malignant LN than benign LN. Although most of these studies implement acoustic radiation force impulse imaging (ARFI) and Supersonic shear imaging (SSI), there is a one study used Toshiba SWE (T-SWE) for evaluating cervical LAP, the same technique that we used in this study 24 .…”

Section: Discussionmentioning

confidence: 95%

Differentiating cervical metastatic lymphadenopathy and lymphoma by shear wave elastography

Chae

Jung

Ryoo

et al. 2019

Sci Rep

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Shear wave elastography (SWE) is a recent technological advance of ultrasonography (US) to assess tissue stiffness. The purpose of this study is to assess tissue stiffness of malignant cervical lymph nodes (LN) with SWE, to reveal diagnostic performance of SWE in differentiating metastatic LN from lymphoma, and to assess inter-observer agreement of SWE. We assessed 62 malignant LN (24 lymphomas and 38 metastatic LN) and their median speed was 6.34 m/s and median elasticity was 69.7 kPa. Add of SWE with conventional US improved diagnostic accuracy of differentiating metastasis from lymphoma (16.13, 8.07 and 11.3% for three radiologists). Kendall’s Coefficient of Concordance of three readers for analyzing SWE patterns was 0.86. SWE can be a useful tool to discriminate metastatic cervical LN from lymphoma with improvement of diagnostic accuracy when using with conventional US.

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“…Compared with strain elastography using hand compression, SWE based on supersonic shear imaging can quantitatively measure the velocity in real-time and indirectly measure the stiffness in KiloPascals (kPa) with more reproducibility. [17, 18] The most recent meta-analysis showed that SWE is an acceptable modality for diagnosing malignant cervical lymph nodes, and demonstrated a summary sensitivity of 81% and specificity of 85%. [19] And, SWE is a reproducible quantitative tool that can be used to characterize sLN of patients with NPC.…”

Section: Introductionmentioning

confidence: 99%

“…[19] And, SWE is a reproducible quantitative tool that can be used to characterize sLN of patients with NPC. [18]…”

Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: Ultrasound Elastography supplement assessing nodal status of magnetic resonance imaging staged cervical N0 patients with nasopharyngeal carcinoma

Han

et al. 2019

Cancer Imaging

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Background To determine whether ultrasound elastography can distinguish reactive or metastatic small lymph nodes (sLN) of magnetic resonance imaging (MRI) staged cervical N0 patients with nasopharyngeal carcinoma (NPC). Methods A pilot study was performed involving the diagnostic performances of conventional high-frequency ultrasound (CHFU) and/or shear wave elastography (SWE) for predicting metastases in sLN of MRI-staged N0 NPC patients with reference to the histologically-proven ultrasound guided core needle biopsy (US-CNB). The diagnosis of CHFU was based on the superficial lymph node ultrasonic criteria with the five-point-scale (FPS). The mean (Emean), minimum (Emin) and maximum (Emax) of the elasticity indices were measured by SWE at the stiffest part of the sLN in kilopascal. Diagnostic performances were analyzed using a receiver operating curve (ROC) on a per-node basis. The authenticity of this article has been validated by uploading the key raw data onto the Research Data Deposit public platform ( http://www.researchdata.org.cn ), with the approval RDD number as RDDA2017000447. Results All 113 cervical sLN of 49 MRI-staged cervical N0 NPC patients underwent evaluation of CHFU and SWE; 38 sLN (FPS < 2) were regarded as benign, which were excluded from subsequent analysis due to none biopsy-proven. And 75 indeterminate sLN (FPS ≥ 2) were referred to US-CNB and revealed 15 (20%) metastases. All SWE elastic indices were significantly higher in malignant sLNs than in benign sLNs ( p < 0.05). Moreover, Emax exhibited the highest diagnostic value (AUC:0.733 ± 0.067, p = 0.005) with excellent measurement reproducibility (ICC: 0.786; 95%CI: 0.684, 0.864). CHFU plus SWE was superior to CHFU or SWE alone for predicting metastases in sLN of MRI-staged N0 patients with NPC ( p < 0.001). Conclusions CHFU plus SWE is an optional non-invasive modality to supplement MRI in assessing cervical nodal status of patients with NPC. Electronic supplementary material The online version of this article (10.1186/s40644-019-0199-3) contains supplementary material, which is available to authorized users.

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The value of shear wave elastography in predicting for undiagnosed small cervical lymph node metastasis in nasopharyngeal carcinoma: A preliminary study

Cited by 22 publications

References 33 publications

Value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in papillary thyroid carcinoma

Value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in papillary thyroid carcinoma

Differentiating cervical metastatic lymphadenopathy and lymphoma by shear wave elastography

RETRACTED ARTICLE: Ultrasound Elastography supplement assessing nodal status of magnetic resonance imaging staged cervical N0 patients with nasopharyngeal carcinoma

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