Shear wave elastography of lymph nodes in dogs with head and neck cancer: A pilot study

Abstract

Shear wave elastography (SWE) is a novel ultrasound imaging technique, used in human medicine to differentiate metastatic from non‐metastatic lymph nodes (LNs) based on higher tissue stiffness. The objective of this pilot study was to evaluate whether canine metastatic LNs were stiffer compared to non‐metastatic LNs. SWE of sentinel or regional LNs in dogs with head and neck cancer was performed. Ten elastograms of each LN were acquired. In each elastogram, mean, median, and maximum shear wave velocities (SWVs) were calculated in the most elastic region, the stiffest region, and the entire LN. The means of those SWVs for each region of each LN were subsequently calculated. Furthermore, a stepwise subsampling was performed to assess the effect of the number of acquired elastograms on the consistency of the classification of a LN as metastatic or not. Twenty‐four LNs in 15 dogs with head and neck cancer were included, of which 10 LNs were metastatic. Metastatic medial retropharyngeal and mandibular LNs were successfully distinguished from non‐metastatic LNs based on higher mean and median SWVs in the stiffest region and higher maximum SWVs in entire LNs. Furthermore, maximum SWVs in the stiffest region of mandibular LNs were higher in metastatic LNs compared to non‐metastatic LNs. Downstream analyses demonstrated that at least eight elastograms were necessary to perform reliable analyses. This pilot trial demonstrated that SWE has potential to discriminate metastatic from non‐metastatic LNs; however, LN status should be based on at least eight elastograms in future clinical trials.

Application of real time shear wave elastography to the differential diagnosis of secondary parathyroid hyperplasia and adenoma

“…Our findings suggested that the values of E-max, E-mean, and E-min in the adenoma group were significantly higher than those in the hyperplasia group, indicating that the hardness of parathyroid adenoma was greater than that of parathyroid hyperplasia, which is consistent with the pathological changes. [14,15] The results indicated that the volume, blood flow, PTH concentration, and elastic modulus of the joint focus were of high value in diagnosing parathyroid adenoma. The AUC was 0.892 (P < .001), sensitivity was 78.9%, specificity was 97.4%, and ultrasonic elastic imaging was a simple, operator-independent, repeatable method.…”

Effectiveness of 2‐dimensional shear wave elastography for noninvasive and reliable estimation of right atrial pressure in dogs with induced volume overload

“… 7 , 8 SWV is reported in meters per second, and its elevation shows a higher elastic modulus in the organ. In veterinary medicine, these investigations were used in previous studies to predict hepatic fibrosis, 9 discriminate metastatic and nonmetastatic lymph nodes, 10 evaluate renal tissue stiffness, 11 distinguish benign and malignant mammary gland neoplasms, 12 and in dogs with extrahepatic biliary obstruction. 13 In addition, a recent veterinary research evaluated the influence of anesthesia to a hepatic elastic modulus measured by 2D‐SWE; however, the results have been inconsistent, with a study reporting a higher elastic modulus in anesthetized than in awake dogs, 14 and another showing the opposite effect.…”

Shear wave elastography evaluation of cats with chronic kidney disease

“…14 There are multiple recent studies evaluating the role of shear wave elastography in veterinary medicine, including the liver in healthy dogs 15 and cats 16 as well as hepatic fibrosis in dogs. 17 Shear wave elastography has also been used to evaluate sentinel lymph nodes 18 in dogs.…”