The effect of regions-of-interest and elasticity modulus selection on differentiating benign and malignant cervical lymph nodes with shear wave elastography

Impact of Region-of-Interest Size on the Diagnostic Performance of Shear Wave Elastography in Differentiating Thyroid Nodules

“…The impact of ROIs in SWE for thyroid nodule evaluation has not been systematically explored in previous research. Various ROI sizes and placements have been employed in the evaluation of breast masses [10][11][12] and lymph nodes [13,14]. In thyroid-related studies, the selection of ROIs has varied widely.…”

“…Additionally, some studies have adopted a mixed approach, which involves using both large and small ROIs [4,30,31]. Smaller ROIs have been demonstrated to be more effective in differentiating benign from malignant lesions in thyroid [4], breast [10], and lymph node [13] examinations. A metaanalysis conducted by Suh et al suggested that the choice of ROI could contribute to the variation in diagnostic performance observed in SWE applications for cervical lymph nodes [16].…”

“…In our examination of the E max data, we discovered that the values for E max(Max) were significantly higher than those for E max(1mm) and E max(2mm) . Studies have often placed the ROI in the stiffest region of a nodule [4,6,13,14,30], frequently resulting in smaller ROIs being positioned in the stiffest area. This practice has led to E max values that are similar to or even higher than those obtained with larger ROIs [13,14].…”

“…SWE minimizes dependence on the skills of the individual operator, leading to high reproducibility and standardized quantitative assessment [2]. Consequently, SWE has emerged as a preferred approach, particularly valued for its quantitative capability in differentiating between various types of lesions, including those occurring in the thyroid [3][4][5][6][7][8][9], breast [10][11][12], and lymph nodes [13,14]. A meta-analysis conducted by Filho et al [15] examined the use of SWE devices from various manufacturers to distinguish between benign and malignant thyroid nodules.…”

“…The selection of the size of regions of interest (ROIs) has emerged as a significant contributor to SWE's performance [16]. This contribution has been explored in the context of breast [10][11][12] and lymph node [13,14] assessments. In the field of thyroid disease research, various parameters and cutoff values have been employed, leading to methodological inconsistencies.…”