Quantitative and Qualitative Assessment of Superficial Lymph Nodes by B-mode Ultrasound, Color Doppler and Sono Elastography | ||||
| SECI Oncology Journal | ||||
| Volume 12, Issue 3, July 2024, Page 262-269 | ||||
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| Abstract | ||||
| Background: Large number of patients with superficial lymphadenopathy undergo biopsy to differentiate benign and malignant lymph nodes (LNs). Although high accuracy of high-resolution sonography approaches differentiating benign and malignant lymph nodes, Ultrasound elastography (USE) explains that pathological changes are linked to changes in tissue stiffness or elasticity. We suggest the application of elastography may decrease using of invasive maneuvers for low-risk LN and improve the selection of LN with high malignant probability. The aim of our study is to evaluate the diagnostic accuracy of B-mode Ultrasound, color Doppler, elastography, and their combination to differentiate benign and malignant LNs. Methods: This was a prospective study included 70 patients with enlarged superficial LNs ranging in age from 3 to 82 years old. Using high frequency probes at 9L / ML6-15 MHz from GE Medical Systems, all patients underwent ultrasound, color Doppler scans, and elastography. Patients were subjected to fine needle aspiration cytology, core biopsy, or excisional biopsy according to patient’s condition, with histopathological examination. Results: Based on strain elastography (SE); malignant lesions had strain elastography score 3 and 4 compared to benign lesions (92.3%) had strain elastography score 1 and 2, the difference was statistically significant (p-value < 0.001). The mean strain ratio ± standard deviation (SD) of benign lesions was 0.84 ± 0.34, the mean strain ratio ± SD of malignant lesions was 2.91±1.05. The difference was statistically significant (p-value < 0.001). Based on shear wave elastography (SWE), 79.5% of malignant lesions had rim and undetermined shear wave color pattern compared to all benign lesions had homogenous and nodular shear wave color pattern, the association was statistically significant (p- value < 0.001). The mean maximum stiffness and maximum velocity were statistically significantly higher among the malignant lesions (p-value < 0.001). Conclusion: Elastography is a non-invasive technique that provides a great promise in distinguishing reactive from malignant lymphadenopathy. Sensitivity can be enhanced when used in conjunction with Doppler and grayscale US. In comparison to greyscale ultrasonography, strain and shear wave elastography provides quantitative and quantitative information on LNs with good diagnostic accuracy differentiating benign and malignant ones. | ||||
| Keywords | ||||
| Ultrasound; Elastography; Superficial Lymphadenopathy | ||||
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