Ultrasound elastography as an adjuvant to conventional ultrasound in the preoperative assessment of axillary lymph nodes in suspected breast cancer: A pilot study

Taylor, Kathryn M.; O'Keeffe, S.A.; Britton, P.D.; Wallis, Matthew; Treece, GM; Housden, James; Parashar, Deepak; Bond, Simon; Sinnatamby, R.

doi:10.1016/j.crad.2011.05.015

Cited by 63 publications

(51 citation statements)

References 24 publications

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“…Analysis of elastography data combined with B-mode sonography proved to have 92% sensitivity, 94% specificity, and 93% accuracy in a correct interpretation of the cervical lymph nodes [8] with good agreement between observers [9]. Hard area in the lymph node in more than 45 % [8] or 50% [10] is considered to be criteria for malignancy. Intense homogenous enhancement pattern is described for benign lymph nodes or lymphoma and inhomogeneous enhancement for metastases [11].…”

Section: Discussionmentioning

confidence: 99%

The utility of elastography and CEUS for the differentiation between benign and malignant cervical lymphadenopaty. Three cases report

et al. 2013

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Section: Discussionmentioning

confidence: 99%

The utility of elastography and CEUS for the differentiation between benign and malignant cervical lymphadenopaty. Three cases report

et al. 2013

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“…Taylor et al [22] compared the lymph node and the (nonspecified) background tissue while Choi et al [23] calculated the strain ratio of the lymph node and subcutaneous fat tissue.…”

Section: Figmentioning

confidence: 99%

Differentiating benign from malignant superficial lymph nodes with sonoelastography

et al. 2013

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The aim of the paper is to provide a comprehensive overview on the applications of real time sonoelastography (SE) in the diagnosis of superficial lymphadenopathy. Some technical aspects of performing SE are presented as a preamble. The typical appearance of benign and malignant nodes is illustrated. The paper discusses and depicts the various elastographic scores in use. It also provides a critical appraisal of the relative strain ratio (SR) or stiffness index. Shear wave elastography, as a novel technique, is mentioned. In conclusion, hardness on more than 50% of the node surface or SR > 1.5 is fair to good indicators of malignancy. Work is still needed both to fully understand the various appearance of disease and to standardize the application.Keywords: sonoelastography, lymph nodes, neoplasm Accurate assessment of the superficial lymph node status is of paramount importance in the treatment planning, follow-up and prognosis of malignancies originating in the head and neck, breast, superficial tissues or in lymphoma. Ultrasonography (US) is extensively used as a first line diagnostic means, due to its cost-effectiveness, ease of use and high resolution of provided information. However, grey-scale and Doppler information are limited either in sensitivity or specificity and no single US criterion has sufficient diagnostic accuracy [1][2][3][4][5].Sonoelastography (SE) depicts the relative stiffness of tissues. Beyond breast, prostate and thyroid applications, over the last five years, the method was also used as a complimentary imaging technique to conventional US for the assessment of superficial lymph nodes [6][7][8][9]. Assessment of nodal SE information is done either by grading the appearance on a score system (elasticity score -ES) or by calculating a relative stiffness or strain ration (SR) [10].The aim of this paper is to review the current status of the knowledge on the applications of SE in the diagnosis of the character of superficial lymphadenopathy. Technical aspectsReal-time sonoelastography is, essentially, an elaborate speckle tracking technique with autocorrelation for out-of-plane displacement of the target [11,12]. It provides information about the relative stiffness of the structures within the scan plane, inside a region of interest (ROI). It is, therefore, important to encompass in the scan area not only the target lesion but also surrounding "normal" reference soft tissues. There are no standard recommendations on how to achieve this. In our experience [13,14], the upper limit of the ROI should always be placed as close to the transducer as possible. When aiming to use ES, the ROI should exceed the target boundaries at least 5 mm on each side. When the purpose is to calculate SR, the ROI should be as wide as possible, to encompass both the target lesion and the surrounding, reference tissue, at the same depth with the lesion. Transducer stabilizer, although desirable, is difficult to use of curved surfaces such as neck or axilla. During compression the transducer should be perpen...

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“…The principle of imaging limits the diagnostic accuracy in differentiating cervical LNs due to a certain amount of overlap in stiffness between benign and malignant Lns 12,17) . In our research, 43 of 52 benign LNs were correctly diagnosed, but VTTQ is a novel elastography technique which assesses tissue elastic properties by SWV.…”

Section: Discussionmentioning

confidence: 99%

“…This potentially improves the characterization of tissues and focal lesions in an objective way. VTTQ has been used in diagnosis of hepatic disease and breast lesions [8][9][10][11] , but there are few reports about VTTQ technique in LNs examination 12,13) . Thus we proposed a study to assess the VTTQ technique in differentiating malignant from benign LNs by contrasting with SR.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Virtual Touch Tissue Quantification with Strain Ratio in Differentiating Malignant from Benign Cervical Lymph Nodes

Sun

Qiu

et al. 2015

J. Hard Tissue Biology.

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The aim of this study was to compare the diagnostic value of virtual touch tissue quantification (VTTQ) and strain ratio (SR) in differentiating malignant from benign cervical lymph nodes (LNs). The local institutional review board approved the study, and all patients provided written informed consent. A total of 144 LNs in 144 patients were examined with ultrasound elastography (UE) to obtain the SR, and with VTTQ technique to obtain the shear wave velocity (SWV) before taking core biopsies for standard reference. A receiveroperating characteristic (ROC) curve was generated to obtain the area under the curve (AUC) and the optimal cut-off point, after which the sensitivity, specificity, and accuracy of the two techniques were compared. In 144 LNs, 52 LNs were benign and 92 LNs were malignant. With ROC curve analysis, the optimal cut-off point was 2.170 for SR and 2.507 for VTTQ. The sensitivity, specificity and accuracy of SR and VTTQ were 78.26 %, 82.69 %, 79.86 % and 89.13 %, 90.38 %, 89.58 %, respectively. Specificity and accuracy were significantly higher for VTTQ than for SR (P<0.05). VTTQ is more accurate than SR in differential diagnosis of benign and malignant cervical LNs.

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Ultrasound elastography as an adjuvant to conventional ultrasound in the preoperative assessment of axillary lymph nodes in suspected breast cancer: A pilot study

Cited by 63 publications

References 24 publications

The utility of elastography and CEUS for the differentiation between benign and malignant cervical lymphadenopaty. Three cases report

The utility of elastography and CEUS for the differentiation between benign and malignant cervical lymphadenopaty. Three cases report

Differentiating benign from malignant superficial lymph nodes with sonoelastography

Comparison of Virtual Touch Tissue Quantification with Strain Ratio in Differentiating Malignant from Benign Cervical Lymph Nodes

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