Xuan Liu, Yi-Ni Huang, Ying-Lan Wu, Xiao-Yao Zhu, Ze-Ming Xie, Jian Li
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The diagnostic performances of US, SWE, UE<sub>or</sub> (either US or SWE was positive) and UE<sub>and</sub> (both US and SWE were positive), and FNAB guided by the above four methods for evaluating ALN status were assessed using receiver operator characteristic curve (ROC) analyses. Univariate and multivariate logistic regression analyses used to determine the independent predictors of axillary burden.</p><p><strong>Results: </strong>The area under the ROC curve (AUC) for diagnosing ALNs using conventional US and SWE were 0.69 and 0.66, respectively, with sensitivities of 78.00% and 65.00% and specificities of 60.98% and 66.67%. The combined method, UE<sub>or</sub>, demonstrated significantly improved sensitivity of 86.00% (p < 0.001 when compared with US and SWE alone). The AUC of the UE<sub>or</sub>-guided FNAB [0.85 (95% CI, 0.80-0.90)] was significantly higher than that of US-guided FNAB [0.83 (95% CI, 0.78-0.88), p = 0.042], SWE-guided FNAB [0.79 (95% CI, 0.72-0.84), p = 0.001], and UE<sub>and</sub>-guided FNAB [0.77 (95% CI, 0.71-0.82), p < 0.001]. Multivariate logistic regression showed that FNAB and number of suspicious ALNs were found independent predictors of axillary burden in patients with early breast cancer.</p><p><strong>Conclusion: </strong>The UE<sub>or</sub> had superior sensitivity compared to US or SWE alone in ALN diagnosis. The UE<sub>or</sub>-guided FNAB achieved a lower false-negative rate compared to FNAB guided solely by US or SWE, which may be a promising tool for the preoperative diagnosis of ALNs in early breast cancer, and had the potential implication for the selection of axillary surgical modality.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"229"},"PeriodicalIF":2.9000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365282/pdf/","citationCount":"0","resultStr":"{\"title\":\"The value of quantitative shear wave elastography combined with conventional ultrasound in evaluating and guiding fine needle aspiration biopsy of axillary lymph node for early breast cancer: implication for axillary surgical stage.\",\"authors\":\"Xuan Liu, Yi-Ni Huang, Ying-Lan Wu, Xiao-Yao Zhu, Ze-Ming Xie, Jian Li\",\"doi\":\"10.1186/s12880-024-01407-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To investigate the value of conventional ultrasonography (US) combined with quantitative shear wave elastography (SWE) in evaluating and identifying target axillary lymph node (TALN) for fine needle aspiration biopsy (FNAB) of patients with early breast cancer.</p><p><strong>Materials and methods: </strong>A total of 222 patients with 223 ALNs were prospectively recruited from January 2018 to December 2021. All TALNs were evaluated by US, SWE and subsequently underwent FNAB. The diagnostic performances of US, SWE, UE<sub>or</sub> (either US or SWE was positive) and UE<sub>and</sub> (both US and SWE were positive), and FNAB guided by the above four methods for evaluating ALN status were assessed using receiver operator characteristic curve (ROC) analyses. Univariate and multivariate logistic regression analyses used to determine the independent predictors of axillary burden.</p><p><strong>Results: </strong>The area under the ROC curve (AUC) for diagnosing ALNs using conventional US and SWE were 0.69 and 0.66, respectively, with sensitivities of 78.00% and 65.00% and specificities of 60.98% and 66.67%. The combined method, UE<sub>or</sub>, demonstrated significantly improved sensitivity of 86.00% (p < 0.001 when compared with US and SWE alone). The AUC of the UE<sub>or</sub>-guided FNAB [0.85 (95% CI, 0.80-0.90)] was significantly higher than that of US-guided FNAB [0.83 (95% CI, 0.78-0.88), p = 0.042], SWE-guided FNAB [0.79 (95% CI, 0.72-0.84), p = 0.001], and UE<sub>and</sub>-guided FNAB [0.77 (95% CI, 0.71-0.82), p < 0.001]. Multivariate logistic regression showed that FNAB and number of suspicious ALNs were found independent predictors of axillary burden in patients with early breast cancer.</p><p><strong>Conclusion: </strong>The UE<sub>or</sub> had superior sensitivity compared to US or SWE alone in ALN diagnosis. 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引用次数: 0
摘要
研究目的研究常规超声造影（US）结合定量剪切波弹性成像（SWE）在评估和识别早期乳腺癌患者细针穿刺活检（FNAB）目标腋窝淋巴结（TALN）中的价值：自2018年1月至2021年12月，共前瞻性招募了222名患者，其中有223个ALN。所有 TALN 均通过 US、SWE 进行评估，随后进行 FNAB。使用接收器操作者特征曲线（ROC）分析评估了US、SWE、UEor（US或SWE均为阳性）和UEand（US和SWE均为阳性）以及上述四种方法指导下的FNAB对评估ALN状态的诊断性能。单变量和多变量逻辑回归分析用于确定腋窝负荷的独立预测因素：使用传统 US 和 SWE 诊断 ALN 的 ROC 曲线下面积（AUC）分别为 0.69 和 0.66，敏感性分别为 78.00% 和 65.00%，特异性分别为 60.98% 和 66.67%。联合方法 UEor 的灵敏度显著提高了 86.00%（与单独的 US 和 SWE 相比，P < 0.001）。UEor 引导的 FNAB 的 AUC [0.85 (95% CI, 0.80-0.90)] 明显高于 US 引导的 FNAB [0.83 (95% CI, 0.78-0.88), p = 0.042]、SWE 引导的 FNAB [0.79 (95% CI, 0.72-0.84), p = 0.001] 和 UEand 引导的 FNAB [0.77 (95% CI, 0.71-0.82), p 结论：在 ALN 诊断中，UEor 的灵敏度优于单纯 US 或 SWE。UEor 引导的 FNAB 与仅由 US 或 SWE 引导的 FNAB 相比，假阴性率更低，这可能是早期乳腺癌 ALN 术前诊断的一种有前途的工具，并对腋窝手术方式的选择有潜在影响。
The value of quantitative shear wave elastography combined with conventional ultrasound in evaluating and guiding fine needle aspiration biopsy of axillary lymph node for early breast cancer: implication for axillary surgical stage.
Objectives: To investigate the value of conventional ultrasonography (US) combined with quantitative shear wave elastography (SWE) in evaluating and identifying target axillary lymph node (TALN) for fine needle aspiration biopsy (FNAB) of patients with early breast cancer.
Materials and methods: A total of 222 patients with 223 ALNs were prospectively recruited from January 2018 to December 2021. All TALNs were evaluated by US, SWE and subsequently underwent FNAB. The diagnostic performances of US, SWE, UEor (either US or SWE was positive) and UEand (both US and SWE were positive), and FNAB guided by the above four methods for evaluating ALN status were assessed using receiver operator characteristic curve (ROC) analyses. Univariate and multivariate logistic regression analyses used to determine the independent predictors of axillary burden.
Results: The area under the ROC curve (AUC) for diagnosing ALNs using conventional US and SWE were 0.69 and 0.66, respectively, with sensitivities of 78.00% and 65.00% and specificities of 60.98% and 66.67%. The combined method, UEor, demonstrated significantly improved sensitivity of 86.00% (p < 0.001 when compared with US and SWE alone). The AUC of the UEor-guided FNAB [0.85 (95% CI, 0.80-0.90)] was significantly higher than that of US-guided FNAB [0.83 (95% CI, 0.78-0.88), p = 0.042], SWE-guided FNAB [0.79 (95% CI, 0.72-0.84), p = 0.001], and UEand-guided FNAB [0.77 (95% CI, 0.71-0.82), p < 0.001]. Multivariate logistic regression showed that FNAB and number of suspicious ALNs were found independent predictors of axillary burden in patients with early breast cancer.
Conclusion: The UEor had superior sensitivity compared to US or SWE alone in ALN diagnosis. The UEor-guided FNAB achieved a lower false-negative rate compared to FNAB guided solely by US or SWE, which may be a promising tool for the preoperative diagnosis of ALNs in early breast cancer, and had the potential implication for the selection of axillary surgical modality.
期刊介绍：
BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.
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