Elastography in the assessment of sentinel lymph nodes prior to dissection

Tourasse, Christophe; Dénier, Jean François; Awada, A.; Gratadour, A. C.; Nessah-Bousquet, Karima

doi:10.1016/j.ejrad.2012.04.031

Cited by 44 publications

(53 citation statements)

References 25 publications

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“…In the European Federation of Societies for Ultrasound in Medicine and Biology and World Federation for Ultrasound in Medicine and Biology guidelines for the breast, both strain elastography and SWE were recommended to help in the diagnosis of breast lesions . Meanwhile, two studies investigating sentinel lymph nodes of breast cancer concluded that SWE was not useful since it was difficult to detect micrometastasis similar to our data on MM lesions. In the present study, the elastographic properties were assessed in only one plane, and the percentages of hard tissue were not assessed for the whole lymph node volume, which is a limitation of this study.…”

Section: Discussionsupporting

confidence: 72%

Usefulness of real‐time elastography for diagnosing lymph node metastasis of skin cancer: does elastography potentially eliminate the need for sentinel lymph node biopsy in squamous cell carcinoma?

Tanaka

Kamata

Fukaya

et al. 2019

Acad Dermatol Venereol

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Background The metastatic involvement of regional lymph nodes is the most important prognostic factor for overall survival of skin cancer patients. The sonographic technique of freehand real‐time tissue elastography (RTE), which displays tissue rigidity as a colour overlay of the tissue image, was developed. Objective Our purpose was to evaluate the benefit of RTE for detecting lymph node metastases of skin cancer non‐invasively before operation. Methods We first selected lymph nodes of skin cancer patients which had already been diagnosed by biopsy as being reactive or metastatic, and then retrospectively collected images of RTE and B‐mode and colour Doppler ultrasound on those lymph nodes performed preoperatively. Twenty‐one lymph nodes from 12 patients with squamous cell carcinoma (SCC), 23 lymph nodes from 14 patients with malignant melanoma (MM) and 14 lymph nodes from six patients with extramammary Paget disease (Paget) were investigated. Elastographic images were assessed on a scale of one to four according to the percentage of high elasticity (hard) area (HEA) in the lymph node. Results In all three skin cancers, lymph nodes evaluated as grade 3 or 4 by RTE were metastatic. All lymph nodes evaluated as grade 1 or 2 by RTE were reactive in SCC, whereas some lymph nodes evaluated as grade 1 or 2 were metastatic in MM and Paget. Conclusion Real‐time tissue elastography may aid in distinguishing reactive lymph nodes from metastatic ones especially in SCC.

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Section: Discussionsupporting

confidence: 72%

Usefulness of real‐time elastography for diagnosing lymph node metastasis of skin cancer: does elastography potentially eliminate the need for sentinel lymph node biopsy in squamous cell carcinoma?

Tanaka

Kamata

Fukaya

et al. 2019

Acad Dermatol Venereol

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“…The positive predictive value for malignancy increases with increasing elasticity [23]. It is however important to note that after the initial reports claiming outstanding diagnostic accuracy values for SWE in the diagnosis of breast and head and neck cancers and axillary lymph nodes [23][24][25][26], recent better controlled and non-industrysponsored studies have shown that elastography did not improve the diagnostic accuracy of conventional (gray-scale and power Doppler) ultrasound studies [27,28].…”

Section: Strain Elastography Of Axillary Nodes In Breast Cancermentioning

confidence: 99%

Strain Elastography of Abnormal Axillary Nodes in Breast Cancer Patients Does Not Improve Diagnostic Accuracy Compared With Conventional Ultrasound Alone

Park

Fornage

Benveniste

et al. 2014

American Journal of Roentgenology

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“…Therefore, detecting and assessing the sentinel lymph node (SLN), which is the first lymph node to which cancer cells drain from a primary tumor, is crucial. To identify the SLN, researchers have explored numerous biomedical imaging techniques . Classically, lymphoscintigraphy with radiocolloid injection has been widely used for preoperative lymph node imaging, but its imaging resolution is relatively low .…”

Section: Introductionmentioning

confidence: 99%

“…To identify the SLN, researchers have explored numerous biomedical imaging techniques. [3][4][5][6][7][8][9][10] Classically, lymphoscintigraphy with radiocolloid injection has been widely used for preoperative lymph node imaging, but its imaging resolution is relatively low. 5 Magnetic resonance imaging (MRI) has shown promising results for nodal staging, but MRI is not cost effective and imaging lymph nodes during surgery and/or biopsies is challenging.…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced ultrasound imaging in vivo with laser-activated nanodroplets

et al. 2017

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Purpose This study introduces a real-time contrast-enhanced ultrasound imaging method with recently developed laser-activated nanodroplets (LANDs), a new class of phase-change nanometer-scale contrast agents that provides perceptible, sustained high-contrast with ultrasound. Methods In response to pulsed laser irradiation, the LANDs—, which contain liquid perfluorohexane and optical fuses—blink (vaporize and recondense). That is, they change their state from liquid nanodroplets to gas microbubbles, and then back to liquid nanodroplets. In their gaseous microbubble state, the LANDs provide high-contrast ultrasound, but the microbubbles formed in situ typically recondense in tens of milliseconds. As a result, LAND visualization by standard, real-time ultrasound is limited. However, the periodic optical triggering of LANDs allows us to observe corresponding transient, periodic changes in ultrasound contrast. This study formulates a probability function that measures how ultrasound temporal signals vary in periodicity. Then, the estimated probability is mapped onto a B-scan image to construct a LAND-localized, contrast-enhanced image. We verified our method through phantom and in vivo experiments using an ultrasound system (Vevo 2100, FUJIFILM VisualSonics, Inc., Toronto, ON, Canada) operating with a 40-MHz linear array and interfaced with a 10 Hz Nd:YAG laser (Phocus, Opotek Inc., Carlsbad, CA, USA) operating at the fundamental 1064 nm wavelength. Results From the phantom study, the results showed improvements in the contrast-to-noise ratio of our approach over conventional ultrasound ranging from 129% to 267%, with corresponding execution times of 0.10 s to 0.29 s, meaning that the developed method is computationally efficient while yielding high-contrast ultrasound. Furthermore, in vivo sentinel lymph node (SLN) imaging results demonstrated that our technique could accurately identify the SLN. Conclusions The results indicate that our approach enables efficient and robust LAND localization in real time with substantially improved contrast, which is essential for the successful translation of this contrast agent platform to clinical settings.

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Elastography in the assessment of sentinel lymph nodes prior to dissection

Cited by 44 publications

References 25 publications

Usefulness of real‐time elastography for diagnosing lymph node metastasis of skin cancer: does elastography potentially eliminate the need for sentinel lymph node biopsy in squamous cell carcinoma?

Usefulness of real‐time elastography for diagnosing lymph node metastasis of skin cancer: does elastography potentially eliminate the need for sentinel lymph node biopsy in squamous cell carcinoma?

Strain Elastography of Abnormal Axillary Nodes in Breast Cancer Patients Does Not Improve Diagnostic Accuracy Compared With Conventional Ultrasound Alone

Contrast-enhanced ultrasound imaging in vivo with laser-activated nanodroplets

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