Affiliations 

  • 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 2 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Radiology, Faculty of Medicine, University Teknologi MARA, Sungai Buloh Campus, Malaysia
  • 3 Department of Radiology, Faculty of Medicine, University Teknologi MARA, Sungai Buloh Campus, Malaysia
  • 4 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: kartini@ummc.edu.my
Acad Radiol, 2022 Jan;29 Suppl 1:S69-S78.
PMID: 33926793 DOI: 10.1016/j.acra.2021.03.018

Abstract

OBJECTIVES: This study evaluates the diagnostic performance of shear wave elastography (SWE) in differentiating between benign and axillary lymph node (ALN) metastasis in breast carcinoma.

MATERIALS AND METHODS: Breast lesions and axillae of 107 patients were assessed using B-mode ultrasound and SWE. Histopathology was the diagnostic gold standard.

RESULTS: In metastatic axillary lymph nodes, qualitative SWE using color patterns had the highest area under curve (AUC) value, followed by B-mode Ultrasound (cortical thickening >3 mm) and quantitative SWE using Emax of 15.2 kPa (AUC of 81.3%, 70.1%, and 61.2%, respectively). Qualitative SWE exhibited better diagnostic performance than the other two parameters, with sensitivity of 96.0% and specificity of 56.1%. Combination of B-mode Ultrasound (using cortical thickness of >3 mm as cut-off point) and qualitative SWE (Color patterns of 2 to 4) showed sensitivity of 71.6%, specificity of 95%, PPV of 96%, NPV of 66.7%, and accuracy of 80.4%.

CONCLUSION: Qualitative SWE assessment exhibited higher accuracy compared to quantitative values. Qualitative SWE as an adjunct to B-mode ultrasound can further improve the diagnostic accuracy of metastatic ALN in breast cancer.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.