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Pre-Operative Evaluation of Axillary Lymph Node Status in Patients with Suspected Breast Cancer Using Shear Wave Elastography.

 Ji Hyun Youk  ;  Eun Ju Son  ;  Jeong-Ah Kim  ;  Hye Mi Gweon 
 ULTRASOUND IN MEDICINE AND BIOLOGY, Vol.43(8) : 1581-1586, 2017 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Axilla ; Breast Neoplasms/pathology* ; Elasticity Imaging Techniques/methods* ; Female ; Humans ; Lymph Nodes/diagnostic imaging* ; Lymph Nodes/pathology ; Lymphatic Metastasis/diagnostic imaging* ; Lymphatic Metastasis/pathology ; Middle Aged ; Preoperative Care/methods* ; Retrospective Studies ; Ultrasonography, Mammary/methods* ; Young Adult
Axilla ; Lymph node ; Shear wave elastography ; Sonoelastography ; Ultrasonography
The aim of this study was to evaluate shear wave elastography (SWE) for pre-operative evaluation of axillary lymph node (LN) status in patients with suspected breast cancer. A total of 130 axillary LNs in 130 patients who underwent SWE before fine-needle aspiration, core biopsy or surgery were analyzed. On gray-scale images, long and short axes, shape (elliptical or round), border (sharp or unsharp) and cortical thickening (concentric, eccentric or no fatty hilum) of LNs were assessed. On SWE, mean, maximum, minimum, standard deviation and the lesion-to-fat ratio (Eratio) values of elasticity were collected. Gray-scale and SWE features were compared statistically between metastatic and benign LNs using the χ2-test and independent t-test. Diagnostic performance of each feature was evaluated using the area under the receiver operating characteristic curve (AUC). Logistic regression analysis was used to determine gray-scale or SWE features independently associated with metastatic LNs. Of the 130 LNs, 65 (50%) were metastatic and 65 (50%) were benign after surgery. Metastatic LNs were significantly larger (p = 0.018); had higher elasticity indexes at SWE (p < 0.0001); and had higher proportions of round shape (p = 0.033), unsharp border (p = 0.048) and eccentric cortical thickening or no fatty hilum (p = 0.005) compared with benign LNs. On multivariate analysis, Eratio was independently associated with metastatic LNs (odds ratio = 3.312, p = 0.008). Eratio had the highest AUC among gray-scale (0.582-0.719) and SWE (0.900-0.950) variables. SWE had good diagnostic performance in metastatic axillary LNs, and Eratio was independently associated with metastatic LNs.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Gweon, Hye Mi(권혜미) ORCID logo https://orcid.org/0000-0002-3054-1532
Kim, Jeong Ah(김정아) ORCID logo https://orcid.org/0000-0003-4949-4913
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
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