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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2025; 35(03): 418-423
DOI: 10.1055/s-0044-1800881
Original Article

Evaluation of Benign and Malignant Cervical Lymphadenopathy: A Comparative Study of Shear Wave Elastography and Grayscale Ultrasound

Gaurav Gaurav
1   Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
,
Shahina Bano
1   Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
,
Prajwala Gupta
2   Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
› Author Affiliations
Funding None.
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Abstract

Objectives The aim of the study was to evaluate role of shear wave elastography (SWE) using a novel methodology for differentiation of benign and malignant cervical lymph nodes.

Materials and Methods SWE was performed on 38 patients who presented with cervical lymph adenopathy. Color-coded elasticity maps were obtained, from which the stiffest region of interest (ROI) with a diameter of 2 mm was chosen. Maximum and mean Young's modulus values (Kpa) were calculated in selected 2-mm ROI. Finally, the results were correlated with the fine needle aspiration cytology findings in all patients to assess the diagnostic accuracy, sensitivity, and specificity at a defined cutoff value for distinguishing between benign and malignant lymphadenopathies.

Results There were 20 malignant cervical lymph nodes and 18 benign cervical lymph nodes. Malignant nodes showed significantly higher mean Young's modulus value (154.2 ± 46.19 kPa) compared with benign nodes (70.39 ± 30.76 kPa), with a p-value of less than 0.0001. Our findings indicate that the mean Young modulus value within a standardized 2-mm ROI outperformed grayscale ultrasound in terms of diagnostic accuracy (92.1 vs. 78.9%), sensitivity (100 vs. 80%), and specificity (83.3 vs. 77.7%), with the established cutoff values for high diagnostic accuracy indicating malignancy as greater than 92 for mean Young's modulus with an area under the curve of 0.964.

Conclusion SWE using a standardized 2-mm ROI provides improved sensitivity and diagnostic accuracy for differentiation of benign and malignant lymph node lesions.

Keywords

benign - cervical lymph node - malignant - shear wave elastography - Young's modulus


Publication History

Article published online:
17 December 2024

© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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