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Ex Vivo Shear-Wave Elastography of Axillary Lymph Nodes to Predict Nodal Metastasis in Patients with Primary Breast Cancer

Other Titles
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Authors
 Soong June Bae  ;  Jong Tae Park  ;  Ah Young Park  ;  Ji Hyun Youk  ;  Jong Won Lim  ;  Hak Woo Lee  ;  Hak Min Lee  ;  Sung Gwe Ahn  ;  Eun Ju Son  ;  Joon Jeong 
Citation
 Journal of Breast Cancer, Vol.21(2) : 190-196, 2018 
Journal Title
 Journal of Breast Cancer 
ISSN
 1738-6756 
Issue Date
2018
Keywords
Axilla ; Breast neoplasms ; Elasticity imaging techniques ; Lymphatic metastasis
Abstract
Purpose: There is still a clinical need to easily evaluate the metastatic status of lymph nodes during breast cancer surgery. We hypothesized that ex vivo shear-wave elastography (SWE) would predict precisely the presence of metastasis in the excised lymph nodes. Methods: A total of 63 patients who underwent breast cancer surgery were prospectively enrolled in this study from May 2014 to April 2015. The excised axillary lymph nodes were examined using ex vivo SWE. Metastatic status was confirmed based on the final histopathological diagnosis of the permanent section. Lymph node characteristics and elasticity values measured by ex vivo SWE were assessed for possible association with nodal metastasis. Results: A total of 274 lymph nodes, harvested from 63 patients, were examined using ex vivo SWE. The data obtained from 228 of these nodes from 55 patients were included in the analysis. Results showed that 187 lymph nodes (82.0%) were nonmetastatic and 41 lymph nodes (18.0%) were metastatic. There was significant difference between metastatic and nonmetastatic nodes with respect to the mean (45.4 kPa and 17.7 kPa, p<0.001) and maximum (55.3 kPa and 23.2 kPa, p<0.001) stiffness. The elasticity ratio was higher in the metastatic nodes (4.36 and 1.57, p<0.001). Metastatic nodes were significantly larger than nonmetastatic nodes (mean size, 10.5 mm and 7.5 mm, p<0.001). The size of metastatic nodes and nodal stiffness were correlated (correlation coefficient of mean stiffness, r=0.553). The area under curve of mean stiffness, maximum stiffness, and elasticity ratio were 0.794, 0.802, and 0.831, respectively. Conclusion: Ex vivo SWE may be a feasible method to predict axillary lymph node metastasis intraoperatively in patients undergoing breast cancer surgery.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162681
Files in This Item:
T201802156.pdf Download
DOI
10.4048/jbc.2018.21.2.190
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
박아영(Park, Ah Young)
박종태(Park, Jong Tae)
배숭준(Bae, Soong June)
손은주(Son, Eun Ju) ORCID logo https://orcid.org/0000-0002-7895-0335
안성귀(Ahn, Sung Gwe) ORCID logo https://orcid.org/0000-0002-8778-9686
육지현(Youk, Ji Hyun) ORCID logo https://orcid.org/0000-0002-7787-780X
이학우(Lee, Hak Woo)
임종원(Lim, Jong Won)
정준(Jeong, Joon) ORCID logo https://orcid.org/0000-0003-0397-0005
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