Sonographic Elastography Improves the Sensitivity and Specificity of Axilla Sampling in Breast Cancer: A Prospective Study

Tsai, Wan‐Chen; Lin, C.; Wei, Hung-Kuang; Yu, Ben-Long; Hung, Chen‐Fang; Cheng, Skye Hongiun; Chen, Chii‐Ming

doi:10.1016/j.ultrasmedbio.2012.12.013

Cited by 28 publications

(22 citation statements)

References 15 publications

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“…Our study demonstrated that elastography may provide additional information for the diagnosis of axillary lymph nodes, similar to previous research. [28][29][30] However, Park et al 8 indicated that strain elastography of abnormal axillary lymph nodes in patients with breast cancer did not improve diagnostic accuracy compared with conventional US alone. Different combinations of methods Figure 4.…”

Section: Discussionmentioning

confidence: 99%

Role of Elastography in Axillary Examination of Patients With Breast Cancer

Chang

Wei

Junni

et al. 2018

J of Ultrasound Medicine

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Elastography can improve the sensitivity when disjunctively combined with conventional US for diagnosis of the axillary lymph node status. Despite the low sensitivity, the conjunctive combination of US and elastography can improve the positive predictive value on a large scale. Elastography is a useful adjuvant tool in addition to conventional US for the preoperative assessment of axillary lymph nodes in patients with breast cancer.

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Section: Discussionmentioning

confidence: 99%

Role of Elastography in Axillary Examination of Patients With Breast Cancer

Chang

Wei

Junni

et al. 2018

J of Ultrasound Medicine

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“…Elastography may improve the sensitivity and specificity of axilla sampling in breast cancer . Evans et al demonstrated that using shear wave elastography (SWE), nodal involvement rates ranged from 7% for tumors with a mean stiffness less than 50 kPa to 41% for tumors with a mean stiffness greater than 150 kPa, indicating that the mean stiffness on SWE is an independent predictor of axilla metastasis.…”

Section: Axillary Lymph Node Assessmentmentioning

confidence: 99%

Lymph Node Imaging in Patients with Primary Breast Cancer: Concurrent Diagnostic Tools

Marino

Avendaño

Zapata³

et al. 2019

The Oncologist

128

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The detection of lymph node metastasis affects the management of patients with primary breast cancer significantly in terms of staging, treatment, and prognosis. The main goal for the radiologist is to determine and detect the presence of metastatic disease in nonpalpable axillary lymph nodes with a positive predictive value that is high enough to initially select patients for upfront axillary lymph node dissection. Features that are suggestive of axillary adenopathy may be seen with different imaging modalities, but ultrasound is the method of choice for evaluating axillary lymph nodes and for performing image-guided lymph node interventions. This review aims to provide a comprehensive overview of the available imaging modalities for lymph node assessment in patients diagnosed with primary breast cancer. The Oncologist 2020;25:e231-e242Implications for Practice: The detection of lymph node metastasis affects the management of patients with primary breast cancer. The main goal for the radiologist is to detect lymph node metastasis in patients to allow for the selection of patients who should undergo upfront axillary lymph node dissection. Features that are suggestive of axillary adenopathy may be seen with mammography, computed tomography, and magnetic resonance imaging, but ultrasonography is the imaging modality of choice for evaluating axillary lymph nodes. A normal axillary lymph node is characterized by a reniform shape, a maximal cortical thickness of 3 mm without focal bulging, smooth margins, and, depending on size, a discernable central fatty hilum.The Oncologist 2020;25:e231-e242 www.TheOncologist.com Breast Cancer Figure 7. Radiomics workflow. Reprinted by permission from Springer Nature, from Han et al., Radiomic nomogram for prediction of axillary lymph node metastasis in breast cancer. European Radiology 2019;7:3820-3829 [76].

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“…Ultrasound (US) is applied widely for its convincing and dynamic observation. However, the sensitivity and specificity of ultrasound for lymph node metastasis were unreliable and controversial [ 5 , 6 ]. Owing to radiation and relative lower diagnostic accuracy, computer tomography (CT) is limited in clinic [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The Diagnosis of Metastatic Axillary Lymph Nodes of Breast Cancer By Diffusion Weighted Imaging: a meta-analysis and systematic review

et al. 2016

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BackgroundThe purpose of this meta-analysis was to evaluate the clinical significance of diffusion-weighted imaging in assessing the status of axillary lymph nodes in patients with breast cancer.MethodsWe searched the PubMed, Cochrane, and EMBASE databases, selected studies by inclusion and exclusion criteria, and assessed the quality of selected studies. We explored the source of heterogeneity; calculated sensitivity, specificity, positive and negative likelihood ratios, and pretest probability. A summary receiver operating characteristic curve was performed. Student’s t test was used to compare the different mean apparent diffusion coefficient values of different status lymph nodes.ResultsIn selected 10 studies, a total of 801 patients and 2305 lymph nodes were included following inclusion criteria. All scores of the quality assessment of the included studies were greater than or equal to 10 points. The sensitivity was 0.89 (95 % CI 0.79–0.95), the specificity was 0.83 (95 % CI 0.71–0.91), the positive and negative likelihood ratios were 3.86 (95 % CI 2.75–5.41) and 0.17 (95 % CI 0.09–0.32), the pretest probabilities were 53 and 54 %, the area under the curve were 0.93 (95 % CI 0.90–0.95), respectively. The mean apparent diffusion coefficient value of metastatic lymph nodes was significantly lower than that of nonmetastatic axillary lymph nodes.ConclusionsDiffusion-weighted imaging is a promising tool to discriminate between metastatic and nonmetastatic axillary lymph nodes. Combined with the mean apparent diffusion coefficient value, it can quantitatively diagnose lymph node metastases. Conducting large-scale, high-quality researches can improve the clinical significance of diffusion-weighted imaging to distinguish metastatic and nonmetastatic axillary lymph nodes in patients with breast cancer and provide the evidence to assess the status of axillary lymph nodes.

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Sonographic Elastography Improves the Sensitivity and Specificity of Axilla Sampling in Breast Cancer: A Prospective Study

Cited by 28 publications

References 15 publications

Role of Elastography in Axillary Examination of Patients With Breast Cancer

Role of Elastography in Axillary Examination of Patients With Breast Cancer

Lymph Node Imaging in Patients with Primary Breast Cancer: Concurrent Diagnostic Tools

The Diagnosis of Metastatic Axillary Lymph Nodes of Breast Cancer By Diffusion Weighted Imaging: a meta-analysis and systematic review

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