Comparison of Two Elasticity Scoring Systems in the Assessment of the Cervical Lymph Nodes
Real-time elastography (RTE) and elasticity scoring system is a new diagnostic tool in the evaluation of enlarged cervical lymph nodes (LNs). The aim of the study was to investigate the validity and reliability of two elasticity scoring systems in discriminating cervical lymphadenopathies. Materials...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2014-09-01
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| Series: | Journal of Medical Ultrasound |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929644114000836 |
| _version_ | 1818454423055106048 |
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| author | Wu-Chia Lo Li-Jen Liao |
| author_facet | Wu-Chia Lo Li-Jen Liao |
| author_sort | Wu-Chia Lo |
| collection | DOAJ |
| description | Real-time elastography (RTE) and elasticity scoring system is a new diagnostic tool in the evaluation of enlarged cervical lymph nodes (LNs). The aim of the study was to investigate the validity and reliability of two elasticity scoring systems in discriminating cervical lymphadenopathies.
Materials and methods: The study protocol was approved by the institutional review board of the local ethics committee. Ninety-eight consecutive patients underwent ultrasound-guided fine needle aspiration biopsy after conventional ultrasound and RTE evaluation. Elasticity scores were divided into four and five categories according to signal distribution, based on previously determined models. Two independent raters analyzed the elastographic data.
Results: Final histology revealed 60 benign and 38 malignant cervical LNs. In the four-point scoring system, 41/60 benign LNs were classified as score 1 or 2 and 28/38 malignant nodes as score 3 or 4 [sensitivity 73.7%, specificity 68.3%, positive predictive value (PPV) 59.6%, negative predictive value (NPV) 80.4%]. Using the five-point scoring system, 28/60 benign nodes were classified as score 1 or 2 and 31/38 malignant nodes as score 3–5 (sensitivity 79.0%, specificity 45.0%, PPV 47.6%, NPV 80.4%). In the four-point scoring system, rates of concordance between raters (κ = 0.63) and with the same rater (κ = 0.75) were both good with statistical significance (both p < 0.01). With the five-point scoring system, both kappa statistic tests between raters (κ = 0.68) and with the same rater (κ = 0.68) were also good with statistical significance (both p < 0.01).
Conclusion: For qualitative RTE, the four-point scoring system had value similar to the five-point scoring system in predicting malignancy in cervical LNs. Furthermore, the reliability was comparable in both scoring systems. For the purpose of simplified evaluation, we suggested using the four-point scoring system to rate the qualitative RTE in the future. |
| first_indexed | 2024-12-14T21:54:38Z |
| format | Article |
| id | doaj.art-7adf8d4d7814446ba4e3744d93d99e8e |
| institution | Directory Open Access Journal |
| issn | 0929-6441 |
| language | English |
| last_indexed | 2024-12-14T21:54:38Z |
| publishDate | 2014-09-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Medical Ultrasound |
| spelling | doaj.art-7adf8d4d7814446ba4e3744d93d99e8e2022-12-21T22:46:10ZengWolters Kluwer Medknow PublicationsJournal of Medical Ultrasound0929-64412014-09-0122314014410.1016/j.jmu.2014.05.003Comparison of Two Elasticity Scoring Systems in the Assessment of the Cervical Lymph NodesWu-Chia Lo0Li-Jen Liao1Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, TaiwanDepartment of Otolaryngology, Far Eastern Memorial Hospital, Taipei, TaiwanReal-time elastography (RTE) and elasticity scoring system is a new diagnostic tool in the evaluation of enlarged cervical lymph nodes (LNs). The aim of the study was to investigate the validity and reliability of two elasticity scoring systems in discriminating cervical lymphadenopathies. Materials and methods: The study protocol was approved by the institutional review board of the local ethics committee. Ninety-eight consecutive patients underwent ultrasound-guided fine needle aspiration biopsy after conventional ultrasound and RTE evaluation. Elasticity scores were divided into four and five categories according to signal distribution, based on previously determined models. Two independent raters analyzed the elastographic data. Results: Final histology revealed 60 benign and 38 malignant cervical LNs. In the four-point scoring system, 41/60 benign LNs were classified as score 1 or 2 and 28/38 malignant nodes as score 3 or 4 [sensitivity 73.7%, specificity 68.3%, positive predictive value (PPV) 59.6%, negative predictive value (NPV) 80.4%]. Using the five-point scoring system, 28/60 benign nodes were classified as score 1 or 2 and 31/38 malignant nodes as score 3–5 (sensitivity 79.0%, specificity 45.0%, PPV 47.6%, NPV 80.4%). In the four-point scoring system, rates of concordance between raters (κ = 0.63) and with the same rater (κ = 0.75) were both good with statistical significance (both p < 0.01). With the five-point scoring system, both kappa statistic tests between raters (κ = 0.68) and with the same rater (κ = 0.68) were also good with statistical significance (both p < 0.01). Conclusion: For qualitative RTE, the four-point scoring system had value similar to the five-point scoring system in predicting malignancy in cervical LNs. Furthermore, the reliability was comparable in both scoring systems. For the purpose of simplified evaluation, we suggested using the four-point scoring system to rate the qualitative RTE in the future.http://www.sciencedirect.com/science/article/pii/S0929644114000836cervicalelasticity scoreelastographylymph nodeultrasound |
| spellingShingle | Wu-Chia Lo Li-Jen Liao Comparison of Two Elasticity Scoring Systems in the Assessment of the Cervical Lymph Nodes Journal of Medical Ultrasound cervical elasticity score elastography lymph node ultrasound |
| title | Comparison of Two Elasticity Scoring Systems in the Assessment of the Cervical Lymph Nodes |
| title_full | Comparison of Two Elasticity Scoring Systems in the Assessment of the Cervical Lymph Nodes |
| title_fullStr | Comparison of Two Elasticity Scoring Systems in the Assessment of the Cervical Lymph Nodes |
| title_full_unstemmed | Comparison of Two Elasticity Scoring Systems in the Assessment of the Cervical Lymph Nodes |
| title_short | Comparison of Two Elasticity Scoring Systems in the Assessment of the Cervical Lymph Nodes |
| title_sort | comparison of two elasticity scoring systems in the assessment of the cervical lymph nodes |
| topic | cervical elasticity score elastography lymph node ultrasound |
| url | http://www.sciencedirect.com/science/article/pii/S0929644114000836 |
| work_keys_str_mv | AT wuchialo comparisonoftwoelasticityscoringsystemsintheassessmentofthecervicallymphnodes AT lijenliao comparisonoftwoelasticityscoringsystemsintheassessmentofthecervicallymphnodes |