Role of Sonography and Sonoelastography in Characterisation of Cervical Lymphadenopathy with Pathological Association: A Cohort Study
Introduction: Identification of the nature of lymph nodes is one of the most important parameters for diagnosis in any oncological setting. The lymph nodes help in staging and this directly affects the prognostic outcome and treatment decision. Ultrasound is the preferred imaging method for distingu...
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JCDR Research and Publications Private Limited
2022-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/16195/50832_Final_F(KR)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf |
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| author | Sumit Kaushik Madhu Sharma Lal Bahadur Sharma Ankur Malhotra Deepti Arora Anshul Jain |
| author_facet | Sumit Kaushik Madhu Sharma Lal Bahadur Sharma Ankur Malhotra Deepti Arora Anshul Jain |
| author_sort | Sumit Kaushik |
| collection | DOAJ |
| description | Introduction: Identification of the nature of lymph nodes is one of the most important parameters for diagnosis in any oncological setting. The lymph nodes help in staging and this directly affects the prognostic outcome and treatment decision. Ultrasound is the preferred imaging method for distinguishing between benign and malignant superficial lymph nodes given ease of availability and its low cost. However, there is no reliable and definitive sonographic criterion in ultrasound to categorise lymph nodes as benign or malignant.
Aim: To evaluate the role of sonography and sonoelastography in characterisation of cervical lymphadenopathy and to associate the imaging findings with cytopathology.
Materials and Methods: This was a prospective cohort study, conducted over a period of one year in Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India, constituting a total of 60 patients with enlarged cervical lymph nodes and evaluated on B-mode ultrasound and elastography in the present study. The ultrasonography was performed using either Acuson S3000 ultrasound system (Siemens Medical Solutions, Mountain View, CA) with a 4 to 9 MHz linear transducer for conventional sonography and Acoustic Radiation Force Impulse (ARFI) imaging. Results of radiological findings were tabulated, evaluated and collated with pathological findings.
Results: ARFI imaging displayed a sensitivity and specificity of 80% and 97.5% respectively with a Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of 94.1% and 90.7% respectively in distinguishing malignant from benign cervical lymphadenopathy with the diagnostic accuracy being 91.67%. Using Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of 0.925, a cut-off value for shear wave velocity of 2.98 m/s was obtained.
Conclusion: ARFI is a novel technique which can be used to characterise the nature of cervical lymph nodes. Present study demonstrated high diagnostic accuracy (91.67%) in comparison with histopathological findings, ARFI elastography may help in distinction of benign from malignant nodes in adjunct to the gray scale. |
| first_indexed | 2024-04-10T16:22:04Z |
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| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T16:22:04Z |
| publishDate | 2022-04-01 |
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| spelling | doaj.art-1259356765874fd38f6b591b42246bf12023-02-09T10:57:40ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-04-01164TC01TC0510.7860/JCDR/2022/50832.16195Role of Sonography and Sonoelastography in Characterisation of Cervical Lymphadenopathy with Pathological Association: A Cohort StudySumit Kaushik0Madhu Sharma1Lal Bahadur Sharma2Ankur Malhotra3Deepti Arora4Anshul Jain5Junior Resident, Department of Radiodiagnosis, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Professor, Department of Radiodiagnosis, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Consultant, Moradabad, Uttar Pradesh, India.Professor, Department of Radiodiagnosis, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Associate Professor, Department of Pathology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Junior Resident, Department of Radiodiagnosis, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Introduction: Identification of the nature of lymph nodes is one of the most important parameters for diagnosis in any oncological setting. The lymph nodes help in staging and this directly affects the prognostic outcome and treatment decision. Ultrasound is the preferred imaging method for distinguishing between benign and malignant superficial lymph nodes given ease of availability and its low cost. However, there is no reliable and definitive sonographic criterion in ultrasound to categorise lymph nodes as benign or malignant. Aim: To evaluate the role of sonography and sonoelastography in characterisation of cervical lymphadenopathy and to associate the imaging findings with cytopathology. Materials and Methods: This was a prospective cohort study, conducted over a period of one year in Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India, constituting a total of 60 patients with enlarged cervical lymph nodes and evaluated on B-mode ultrasound and elastography in the present study. The ultrasonography was performed using either Acuson S3000 ultrasound system (Siemens Medical Solutions, Mountain View, CA) with a 4 to 9 MHz linear transducer for conventional sonography and Acoustic Radiation Force Impulse (ARFI) imaging. Results of radiological findings were tabulated, evaluated and collated with pathological findings. Results: ARFI imaging displayed a sensitivity and specificity of 80% and 97.5% respectively with a Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of 94.1% and 90.7% respectively in distinguishing malignant from benign cervical lymphadenopathy with the diagnostic accuracy being 91.67%. Using Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of 0.925, a cut-off value for shear wave velocity of 2.98 m/s was obtained. Conclusion: ARFI is a novel technique which can be used to characterise the nature of cervical lymph nodes. Present study demonstrated high diagnostic accuracy (91.67%) in comparison with histopathological findings, ARFI elastography may help in distinction of benign from malignant nodes in adjunct to the gray scale.https://www.jcdr.net/articles/PDF/16195/50832_Final_F(KR)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdflymph nodeslymphomametastasestuberculous nodesultrasound |
| spellingShingle | Sumit Kaushik Madhu Sharma Lal Bahadur Sharma Ankur Malhotra Deepti Arora Anshul Jain Role of Sonography and Sonoelastography in Characterisation of Cervical Lymphadenopathy with Pathological Association: A Cohort Study Journal of Clinical and Diagnostic Research lymph nodes lymphoma metastases tuberculous nodes ultrasound |
| title | Role of Sonography and Sonoelastography in Characterisation of Cervical Lymphadenopathy with Pathological Association: A Cohort Study |
| title_full | Role of Sonography and Sonoelastography in Characterisation of Cervical Lymphadenopathy with Pathological Association: A Cohort Study |
| title_fullStr | Role of Sonography and Sonoelastography in Characterisation of Cervical Lymphadenopathy with Pathological Association: A Cohort Study |
| title_full_unstemmed | Role of Sonography and Sonoelastography in Characterisation of Cervical Lymphadenopathy with Pathological Association: A Cohort Study |
| title_short | Role of Sonography and Sonoelastography in Characterisation of Cervical Lymphadenopathy with Pathological Association: A Cohort Study |
| title_sort | role of sonography and sonoelastography in characterisation of cervical lymphadenopathy with pathological association a cohort study |
| topic | lymph nodes lymphoma metastases tuberculous nodes ultrasound |
| url | https://www.jcdr.net/articles/PDF/16195/50832_Final_F(KR)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf |
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