Shear Wave Elastography as a Supplement Tool in Differentiating Benign and Malignant Axillary Lymph Nodes

Objectives

To determine the efficacy of quantitative shear wave elastography in differentiating benign and malignant axillary lymph nodes (ALN).

Methods

Exactly 127 lymph nodes from 127 patients with clinically palpable axillary swelling were examined by both B-mode sonography and elastography from November 2022 to March 2024. Gray-scale sonograms were evaluated based on: the short-axis diameter, shape, hilum, maximum cortical thickness, and border of the ALN. Shear wave elastography determined the mean elasticity modulus (E-mean) and elasticity ratio (E-ratio). Fine needle aspiration cytology or histopathological examination was kept as the gold standard and diagnostic performance shear wave elastography was compared.

Results

The data showed that out of 127 lymph nodes, 77 (60.6%) were benign and 50 (39.4%) were malignant based on pathological results. The E-mean for malignant lymph nodes (mean, 73.15 kPa) was higher than that for benign lymph nodes (mean, 21.47 kPa; P < .001). The area under the receiver operating characteristic curve for E-ratio in predicting malignant and benign lymph nodes was 0.897 (95% CI: 0.839–0.955). The E-ratio for malignant lymph nodes was also higher (mean, 10.2) than for benign nodes (mean, 2.95; P < .001). The area under the receiver operating characteristic curve for E-ratio in predicting malignant and benign lymph nodes was 0.816 (95% CI: 0.733–0.899).

Conclusion

Our results showed a significant association between tissue elasticity and pathological correlation.