Predictive value of comb-push ultrasound shear elastography for the differentiation of reactive and metastatic axillary lymph nodes: A preliminary investigation

Autoři: Adriana Gregory aff001;  Max Denis aff001;  Mahdi Bayat aff002;  Viksit Kumar aff002;  Bae Hyung Kim aff002;  Jeremy Webb aff001;  Rohit Nayak aff001;  Saba Adabi aff001;  Duane D. Meixner aff001;  Eric C. Polley aff003;  Robert T. Fazzio aff001;  Mostafa Fatemi aff002;  Azra Alizad aff001
Působiště autorů: Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America aff001;  Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine,Rochester, Minnesota, United States of America aff002;  Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226994



To evaluate the predictive performance of comb-push ultrasound shear elastography for the differentiation of reactive and metastatic axillary lymph nodes.


From June 2014 through September 2018, 114 female volunteers (mean age 58.1±13.3 years; range 28–88 years) with enlarged axillary lymph nodes identified by palpation or clinical imaging were prospectively enrolled in the study. Mean, standard deviation and maximum shear wave elastography parameters from 117 lymph nodes were obtained and compared to fine needle aspiration biopsy results. Mann-Whitney U test and ROC curve analysis were performed.


The axillary lymph nodes were classified as reactive or metastatic based on the fine needle aspiration outcomes. A statistically significant difference between reactive and metastatic axillary lymph nodes was observed based on comb-push ultrasound shear elastography (CUSE) results (p<0.0001) from mean and maximum elasticity values. Mean elasticity showed the best separation with a ROC analysis resulting in 90.5% sensitivity, 94.4% specificity, 0.97 area under the curve, 95% positive predictive value, and 89.5% negative predictive value with a 30.2-kPa threshold.


CUSE provided a quantifiable parameter that can be used for the assessment of enlarged axillary lymph nodes to differentiate between reactive and metastatic processes.

Klíčová slova:

Biopsy – Breast cancer – Cancer detection and diagnosis – Collagens – Lymph nodes – Magnetic resonance imaging – Metastasis – Ultrasound imaging


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