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Shear Wave Elastography in Head and Neck Lymph Node Assessment: Image Quality and Diagnostic Impact Compared with B-Mode and Doppler Ultrasonography

Abstract : The aim of this study was to assess the diagnostic performance of shear wave elastography (SWE) in~comparison to B-mode and Doppler ultrasonography in differentiating benign from malignant head and neck lymph nodes (HNLNs). Sixty-two HNLNs from 56 patients were prospectively examined using B-mode, Doppler and SWE. The standard of reference was histopathology or cytology and follow-up. Qualitative malignant criteria (hilum infiltration, cortical hypo-echogenicity, irregular margins, abnormal vessels) were assessed on a five-point scale. Four quantitative parameters were obtained: long axis length, short axis length, short axis/long axis ratio, resistive index and maximum shear elasticity modulus (μmax). Diagnostic performance was analyzed with special emphasis on the sub-centimeter HNLN subgroup. Thirty HNLNs were malignant (48%). μmax intra-observer reproducibility was 0.899 (0.728 in sub-centimeter subgroup). Malignant HNLNs were stiffer (μmax~=~72.4~±~59.0~kPa) compared with benign nodes (μmax~=~23.3~±~25.3~kPa) (p~<~0.001). Among the quantitative criteria, μmax had the highest diagnostic accuracy (area under the curve~=~0.903~±~0.042), especially in the sub-centimeter subgroup (area under the curve~=~0.929~±~0.045; p~<~0.001) in which the area under the curve was significantly higher compared with the other quantitative criteria (p~<~0.05). The additional use of SWE combined with B-mode tended to improve diagnostic accuracy (p~>~0.05). SWE is a promising reproducible quantitative tool with which to predict malignant HNLNs, especially sub-centimeter nodes.
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Submitted on : Monday, February 28, 2022 - 5:49:14 PM
Last modification on : Tuesday, March 1, 2022 - 3:29:51 AM

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Florian Desmots, Nicolas Fakhry, Julien Mancini, Anthony Reyre, Vincent Vidal, et al.. Shear Wave Elastography in Head and Neck Lymph Node Assessment: Image Quality and Diagnostic Impact Compared with B-Mode and Doppler Ultrasonography. Ultrasound in Medicine & Biology, 2016, 42 (2), pp.387--398. ⟨10.1016/j.ultrasmedbio.2015.10.019⟩. ⟨hal-03591723⟩

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