Diagnostic Accuracy of Shear Wave Elastography as an Adjunct Tool in Detecting Axillary Lymph Nodes Metastasis

Ng, Wei Lin; Omar, Norlia; Mumin, Nazimah Ab; Hamid, Marlina Tanty Ramli; Vijayananthan, A.; Rahmat, Kartini

doi:10.1016/j.acra.2021.03.018

Cited by 16 publications

(22 citation statements)

References 17 publications

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“…The benign ALNs usually manifest color pattern 1, while ALN metastases (ALNMs) usually manifest color patterns 2-4, and the sensitivity, specificity, PPV, NPV, and area under the receiver operating characteristic (ROC) curve (AUC) were 96.7%, 100%, 100%, 96.8%, and 98.3%, respectively (25). In addition, Luo et al (25) and Lin et al (26) directly compared the diagnostic performance of qualitative and quantitative SWE, and they found that qualitative SWE had better diagnostic performance than quantitative SWE in detecting ALNM.…”

Section: Shear Wave-based Elastographymentioning

confidence: 98%

“…Some researchers (25,26) qualitatively classified SWE images of axillary LN (ALN) into 4-point patterns, which was similar to SWE patterns of breast lesions (31): color pattern 1, homogeneous pattern; color pattern 2, filling defect within LN; color pattern 3, homogeneous within LN with a localized colored area at the margin; and color pattern 4, filling defect within LN with a localized colored area at the margin (25). The benign ALNs usually manifest color pattern 1, while ALN metastases (ALNMs) usually manifest color patterns 2-4, and the sensitivity, specificity, PPV, NPV, and area under the receiver operating characteristic (ROC) curve (AUC) were 96.7%, 100%, 100%, 96.8%, and 98.3%, respectively (25).…”

Section: Shear Wave-based Elastographymentioning

confidence: 99%

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Ultrasound Elastography for the Evaluation of Lymph Nodes

et al. 2021

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The differential diagnosis of lymphadenopathy is important for predicting prognosis, staging, and monitoring the treatment, especially for cancer patients. Conventional computed tomography and magnetic resonance imaging characterize lymph node (LN) with disappointing sensitivity and specificity. Conventional ultrasound with the advantage of high resolution has been widely used for the LN evaluation. Ultrasound elastography (UE) using color map or shear wave velocity can non-invasively demonstrate the stiffness and homogeneity of both the cortex and medulla of LNs and can detect early circumscribed malignant infiltration. There is a need of a review to comprehensively discuss the current knowledge of the applications of various UE techniques in the evaluation of LNs. In this review, we discussed the principles of strain elastography and shear wave-based elastography, and their advantages and limitations in the evaluation of LNs. In addition, we comprehensively introduced the applications of various UE techniques in the differential diagnosis of reactive LNs, lymphoma, metastatic LNs, and other lymphadenopathy. Moreover, the applications of endoscopic UE and endobronchial UE are also discussed, including their use for improving the positive rate of diagnosis of fine-needle aspiration biopsy.

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Section: Shear Wave-based Elastographymentioning

confidence: 98%

Section: Shear Wave-based Elastographymentioning

confidence: 99%

Ultrasound Elastography for the Evaluation of Lymph Nodes

et al. 2021

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“…In addition, it provides information on lesions that may not have sonographic contrast that otherwise could have been detected ultrasonically [ 15 ]. Several studies have documented the utility of US elastography in differentiating malignant from benign lesions in breast, thyroid, prostate, and liver, as well as lymph nodes [ 8 , 16 , 17 , 18 , 19 , 20 ], and encouraging findings with higher diagnostic accuracy than B-mode in standard ultrasound [ 21 , 22 ] or as an adjunct technique have been observed [ 16 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

“…The current literature reports different quantitative SWE parameters: E min (minimum stiffness), E mean (mean stiffness), E max (maximum stiffness), and E sd (one standard deviation of stiffness) with different cut-off values for different anatomical lymph node positions [ 12 , 16 , 19 , 22 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. However, more evidence is needed to discuss the significance of the different SWE parameters and their diagnostic potential for lymph node diseases.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Different Quantitative Shear Wave Parameters of Ultrasound Elastography in the Diagnosis of Lymph Node Malignancies: A Systematic Review and Meta-Analysis

Gao

Zhao

Choi

et al. 2022

Cancers

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Shear wave elastography (SWE) has shown promise in distinguishing lymph node malignancies. However, the diagnostic accuracies of various SWE parameters that quantify tissue stiffness are yet to be demonstrated. To evaluate the pooled diagnostic accuracy of different SWE parameters for differentiating lymph node malignancies, we conducted a systematic screening of four databases using the PRISMA guidelines. Lymph node biopsy was adopted as the reference standard. Emax (maximum stiffness), Emean (mean stiffness), Emin (minimum stiffness), and Esd (standard deviation) SWE parameters were subjected to separate meta-analyses. A sub-group analysis comparing the use of Emax in cervical (including thyroid) and axillary lymph node malignancies was also conducted. Sixteen studies were included in this meta-analysis. Emax and Esd demonstrated the highest pooled sensitivity (0.78 (95% CI: 0.69–0.87); 0.78 (95% CI: 0.68–0.87)), while Emean demonstrated the highest pooled specificity (0.93 (95% CI: 0.88–0.98)). From the sub-group analysis, the diagnostic performance did not differ significantly in cervical and axillary LN malignancies. In conclusion, SWE is a promising adjunct imaging technique to conventional ultrasonography in the diagnosis of lymph node malignancy. SWE parameters of Emax and Esd have been identified as better choices of parameters for screening clinical purposes.

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“…Studies have shown that it can be used to differentiate between benign and malignant breast lesions (Kilic et al, 2016; Luo et al, 2019). Recently the method has also been applied to ALN metastasis detection in clinical settings (Ng et al, 2021; Seo & Sohn, 2018; Youk et al, 2017). The potential of this method was also recognized by the American College of Radiology (ACR), who included SWE in the 5th edition of their Breast Imaging Reporting and Data System (BI‐RADS) lexicon (Acharya, Ng, et al, 2017; American College of Radiology and D'Orsi, Carl J, 2013; Berg et al, 2012; Evans et al, 2012; Ng et al, 2016; Olgun et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Fusion of B‐mode and shear wave elastography ultrasound features for automated detection of axillary lymph node metastasis in breast carcinoma

et al. 2022

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In this study, we evaluate and compare the diagnostic performance of ultrasound for non-invasive axillary lymph node (ALN) metastasis detection. The study was based on fusing shear wave elastography (SWE) and B-mode ultrasonography (USG) images.These images were subjected to pre-processing and feature extraction, based on bidimensional empirical mode decomposition and higher order spectra methods. The resulting nonlinear features were ranked according to their p-value, which was established with Student's t-test. The ranked features were used to train and test six classification algorithms with 10-fold cross-validation. Initially, we considered Bmode USG images in isolation. A probabilistic neural network (PNN) classifier was able to discriminate positive from negative cases with an accuracy of 74.77% using 15 features. Subsequently, only SWE images were used and as before, the PNN classifier delivered the best result with an accuracy of 87.85% based on 47 features.Finally, we combined SWE and B-mode USG images. Again, the PNN classifier delivered the best result with an accuracy of 89.72% based on 71 features. These three tests indicate that SWE images contain more diagnostically relevant information when compared with B-mode USG. Furthermore, there is scope in fusing SWE and B-mode USG to improve non-invasive ALN metastasis detection.

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Diagnostic Accuracy of Shear Wave Elastography as an Adjunct Tool in Detecting Axillary Lymph Nodes Metastasis

Cited by 16 publications

References 17 publications

Ultrasound Elastography for the Evaluation of Lymph Nodes

Ultrasound Elastography for the Evaluation of Lymph Nodes

Evaluating Different Quantitative Shear Wave Parameters of Ultrasound Elastography in the Diagnosis of Lymph Node Malignancies: A Systematic Review and Meta-Analysis

Fusion of B‐mode and shear wave elastography ultrasound features for automated detection of axillary lymph node metastasis in breast carcinoma

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