Ultrasonography and Sonoelastography Characteristics of Benign vs. Malignant Mesenteric Lymph Nodes in Cats: An Update

Abstract

(1) Background: Strain elastography (SE) is an ultrasound-based technique able to non-invasively assess tissue elasticity, with malignant tissues being stiffer than normal tissues. The purpose of the study was to evaluate the diagnostic performance of SE to differentiate feline mesenteric benign and malignant lymph nodes (LNs) using a multivariate approach including both SE results and B-mode ultrasound and color Doppler findings. (2) Methods: Feline enlarged mesenteric LNs were evaluated using B-mode ultrasound, color Doppler ultrasonography, and SE. Short-to-long axis ratios, borders, echogenicity, hilum, vascular flow distribution, elastographic patterns, and strain ratios were recorded. Histological and/or cytological diagnosis was available for each LN. (3) Results: A total of 88 LNs were included, 46 (52.3%) benign and 42 (47.7%) malignant; in the benign group, 40 LNs had a diagnosis of reactive hyperplasia (group A) and 6 eosinophilic sclerosing lymphadenitis (group B), while in the malignant group 42 had a diagnosis of lymphoma (group C). The principal component analysis approach showed evidence that by combining B-mode- and color Doppler-based scores with SE scores, the three groups of LNs can be accurately distinguished. (4) Conclusions: Our results demonstrate that a multivariate sonographic approach combining B-mode ultrasound, color Doppler ultrasonography, and SE can accurately distinguish benign from malignant LNs, thus helping in the clinical advice of feline patients.

Use of New Ultrasonography Methods for Detecting Neoplasms in Dogs and Cats: A Review

“…However, lymph nodes with lymphoma and lymphadenitis exhibited some degree of overlap in the classification. Some fibrotic lymph nodes scored higher in the ultrasound classification and showed greater stiffness in elastography, like lymph nodes affected by lymphoma [22].…”

“…Several studies have used elastography for assessing hepatic fibrosis in humans as a preliminary assessment before tissue biopsies or for predicting and detecting malignancy [5,7], as well as for assessing acute and chronic kidney diseases [8]. In veterinary medicine, recent studies have explored elastography for evaluating the prostate [9][10][11], liver [12], and kidneys in dogs and cats [2,9], as well as for assessing hepatic fibrosis [13], lymph nodes [2,[14][15][16][17][18][19][20][21][22], and mammary neoplasms [1,4,[23][24][25]. Elastography has been shown to be a promising diagnostic method in the evaluation and prediction of neoplasm malignancy, mainly due to its safety and low invasiveness [1].…”