Shear Wave Elastography and Cervical Lymph Nodes: Predicting Malignancy

What is it about?

The purpose of this prospective study was to evaluate the performance of shear wave elastography for predicting the risk of malignancy in cervical lymph nodes (LN) in patients presenting to a clinical thyroid practice. Based on the ROC curve, the best single cut-off maximum shear wave velocity (SWV) for predicting malignant LN was 2.93 m/s with a sensitivity of 92.59%. The specificity, PPV and NPV were 75.46%, 48.54% and 97.6%, respectively. Compared with B-mode ultrasound features for predicting malignancy, maximum SWV has a higher sensitivity and a higher NPV that are likely to be clinically useful. In a second analysis, LN were divided into three pre-determined groups based on maximum SWV. In group 3, with the highest SWV >3.2 m/s, 52.44% of LN were malignant. Both the multi cut-off and single cut-off were effective in distinguishing benign from malignant LN. A larger study is required to validate or establish a single or multi cut-off SWV to determine the risk for malignancy in cervical LN. We concluded that LN stiffness measured by VTIQ–generated quantitative shear wave elastography is an independent predictor of malignant LN. Our data suggests that application of shear wave elastography may decrease the number of fine-needle aspiration biopsies for low risk LN and improve the ability to select LN with high probability for malignancy.

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