Department of Abdominal Ultrasound, the Affiliated Hospital of Qingdao University, No.16 Jiang Su Rd, Qingdao 266000, Shandong, China.
Department of Intensive Care Unit, the Affiliated Hospital of Qingdao University, No.16 Jiang Su Rd, Qingdao 266000, Shandong, China.
Clinics (Sao Paulo). 2020 Oct 26;75:e1691. doi: 10.6061/clinics/2020/e1691. eCollection 2020.
Imaging diagnosis of cervical lymphadenopathy has conventionally used ultrasonography. Shear wave elastography (SWE) is a recent ultrasound technological advancement that has shown promise in the important medical problem of differentiating between benign and malignant cervical lymph nodes based on quantitative measurements of elasticity modulus. However, widely varying elasticity modulus metrics and regions-of-interest (ROIs) were used in existing studies, leading to inconsistent findings and results that are hard to compare with each other.
Using a large dataset of 264 cervical lymph nodes from 200 patients, we designed a study comparing three elasticity modulus metrics (Emax, Emean, and standard deviation-SD) with three different ROIs to evaluate the effect of such selections. The metric values were compared between the benign and malignant node groups. The different ROI and metric selections were also compared through receiver operating characteristics curve analysis.
For all ROIs, all metric values were significantly different between the two groups, indicting their diagnostic potential. This was confirmed by the ≥0.80 area under the curve (AUC) values achieved with these metrics. Different ROIs had no effect on Emax, whereas all ROIs achieved high performance at 0.88 AUC. For Emean, the smallest ROI focusing on the area of the highest elasticity achieved the best diagnostic performance. In contrast, the larger ROIs achieved higher performances for SD.
This study illustrated the effect of elasticity modulus and ROI selection on the diagnostic performance of SWE on cervical lymphadenopathy. These new findings help guide relevant future studies and clinical applications of this important quantitative imaging modality.
颈淋巴结病的影像学诊断传统上使用超声检查。剪切波弹性成像（SWE）是最近的超声技术进步，它在根据弹性模量的定量测量来区分良性和恶性颈淋巴结方面显示出了前景。然而，在现有的研究中，广泛使用了不同的弹性模量指标和感兴趣区域（ROI），导致研究结果不一致，难以相互比较。
使用来自 200 名患者的 264 个颈淋巴结的大型数据集，我们设计了一项研究，比较了三种弹性模量指标（Emax、Emean 和标准差-SD）与三种不同的 ROI，以评估这些选择的效果。将度量值在良性和恶性节点组之间进行比较。还通过接收者操作特性曲线分析比较了不同的 ROI 和度量选择。
对于所有 ROI，两组之间的所有度量值均存在显著差异，表明它们具有诊断潜力。这通过这些指标达到的≥0.80 曲线下面积（AUC）值得到证实。不同的 ROI 对 Emax 没有影响，而所有 ROI 的 AUC 均达到 0.88。对于 Emean，聚焦于最高弹性区域的最小 ROI 达到了最佳的诊断性能。相比之下，较大的 ROI 可获得更高的 SD 性能。
本研究说明了弹性模量和 ROI 选择对 SWE 在颈淋巴结病中的诊断性能的影响。这些新发现有助于指导这种重要的定量成像方式的相关未来研究和临床应用。
