Shear Wave Elastography and Cervical Lymph Nodes: Predicting Malignancy

Ultrasound Med Biol. 2016 Jun;42(6):1273-81. doi: 10.1016/j.ultrasmedbio.2016.01.012. Epub 2016 Mar 12.

Abstract

This prospective study evaluates the accuracy of virtual touch imaging quantification (VTIQ), a non-invasive shear wave elastography method for measuring cervical lymph nodes (LN) stiffness in differentiating benign from malignant LN. The study evaluated 270 LN in 236 patients with both conventional B-mode ultrasound and VTIQ shear wave elastography before fine-needle aspiration biopsy (FNAB). LN stiffness was measured as shear wave velocity (SWV) in m/s. Surgical resection was advised for FNAB results that were not clearly benign. Surgical pathology confirmed 54 malignant LN. The receiver operating curve (ROC) identified a single cut-off value of 2.93 m/s as the maximum SWV for predicting a malignant cervical LN. The sensitivity and specificity were 92.59% and 75.46%, respectively. Positive predictive value (PPV) was 48.54% and negative predictive value (NPV) was 97.60%. LN stiffness measured by VTIQ-generated shear wave elastography is an independent predictor of malignancy.

Keywords: Fine-needle aspiration biopsy; Lymph node; Malignancy; Shear wave elastography; Ultrasound.

MeSH terms

  • Diagnosis, Differential
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neck
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Thyroid Neoplasms / pathology*