Diagnostic Accuracy of Sonoelastography for the diagnosis of of malignant cervical lymph nodes by taking histopathology as gold standard

Sonoelastography and malignant cervical nodes

Authors

  • Najia Nazeer Dr. Ziauddin University Hospital Karachi
  • Kamran Hameed Dr. Ziauddin University Hospital Karachi
  • Sheeza Imtiaz Dr. Ziauddin University Hospital Karachi
  • Shamama tul Amber Dr. Ziauddin University Hospital Karachi
  • Bilal Irfan Dr. Ziauddin University Hospital Karachi
  • Sehrish Sheikh Dr. Ziauddin University Hospital Karachi

Abstract

Background: Metastatic cervical lymph nodes from head and neck carcinomas are usually site specific with respect to the location of the primary tumor. Therefore, assessment of the distribution of metastatic nodes in patients with unknown primary may provide a clue to the site
of the primary tumor. Elastography can help in characterizing lymph nodes based on the stiffness of tissues.
Objective: To determine the diagnostic accuracy of sonoelastography for the diagnosis of malignant cervical lymph nodes by taking histopathology as gold standard.
Materials and Methods: A Cross sectional study, prospective study conducted in the Department of Radiology, Dr. Ziauddin University Hospital,
Karachi, from 01-03-2023 to 31-08-2023. A total of 277 patients suspected of having malignancy with palpable clinical cervical lymph nodes were recruited in this study. Informed consent was taken and data was collected in Performa. Brief history of demographic was taken. Cervical lymph nodes were labeled as malignant on elastographic findings and confirmed on histopathology.
Results:The average age of the patients was 50.06±12.56 years. 55.96% were male and 44.04% were female. Incidence of malignant cervical lymph nodes was 36.5% diagnosed by histopathology. Sensitivity, specificity, PPV, NPV and accuracy of sonoelastography for the diagnosis of malignant cervical lymph nodes was 97%, 84.7%, 78.4%, 98% and 89.7% respectively. Conclusion: Sonoelastography is a non-invasive and reliable imaging modality for the diagnosis of malignant cervical lymph nodes.

Author Biographies

Najia Nazeer, Dr. Ziauddin University Hospital Karachi

FCPS resident

Department of Radiology

Kamran Hameed, Dr. Ziauddin University Hospital Karachi

Professor, H.O.D, Director 

Department of Radiology

Sheeza Imtiaz, Dr. Ziauddin University Hospital Karachi

Assistant Professor and Consultant Radiologist

Department of Radiology

Shamama tul Amber, Dr. Ziauddin University Hospital Karachi

Consultant Radiologist

Department of Radiology

Bilal Irfan, Dr. Ziauddin University Hospital Karachi

FCPS resident

Department of Radiology

Sehrish Sheikh, Dr. Ziauddin University Hospital Karachi

FCPS resident

Department of radiology

References

Chavoshi Mr, Taghavi M, Hashemi H, Davoodi M, Rouzrokh P, Aghaghazvini L.Diagnostic Value of Shear Wave Elastography in Differentiation between Benign from Malignant Cervical Lymph Nodes. J Iran Med Counc. 2023;6(4):664-73.

Acu L, Oktar SÖ, Acu R, Yücel C, Cebeci S. Value of ultrasound elastography in the differential diagnosis of cervical lymph nodes: a comparative study with b-mode and color doppler sonography. J Ultrasound Med. 2016;35:2491–99.

Kang HJ, Seo M, Sohn YM, Yun SJ, Min SY, You MW, Yeon EK. Comparison of Diagnostic Performance of B-Mode Ultrasonography and Shear Wave Elastography in Cervical Lymph Nodes. Ultrasound Q. 2019 Sep;35(3):290-96.

Suh CH, Choi YJ, Baek JH, Lee JH. The diagnostic performance of shear wave elastography for malignant cervical lymph nodes: A systematic review and meta-analysis. Eur Radiol. 2017 Jan;27(1):222-30.

Hina Baig, Muhammad Shafiq Ul Azam, Aysha Akram, Asim Ali, Aisha Asim, Rabia Younas. (2023). Diagnostic Accuracy of Elastography to Differentiate Between Malignant and Benign Lymph Nodes of Neck and Head Region Taking Histopathology as Gold Standard. Pakistan Journal of Medical & Health Sciences, 16(11), 894.

Gennisson JL, Deffieux T, Fink M, Tanter M. Ultrasound elastography: principles and techniques. Diagn Interv Imaging 2013 May;94(5):487-95.

Sigrist RM, Liau J, El Kaffas A, Chammas MC, Willmann JK. Ultrasound elastography:review of techniques and clinical applications. Theranostics 2017 Mar 7;7(5):1303-29.

Vineela E, Sakalecha AK, Narayanrao Suresh T. Role of Sonoelastography in Differentiating Benign From Malignant Cervical Lymph Nodes and Correlating with Pathology. Cureus. 2022 Mar 9;14(3):e22984.

Rasheed Bhutta M, Majeed AI, Khan A, Zafar I, Azad H, Akhtar S. Diagnostic Accuracy of Elastography to Differentiate Between Benign and Malignant Lymph Nodes of Head and Neck Region taking Histopathology as the Gold Standard. Pak Armed Forces Med J

73(3):670-73.

McQueen AS, Bhatia KS. Head and neck ultrasound: technical advances, novel applications and the role of elastography. Clin Radiol2018 ;73(1):81-93.

Acu L, Oktar SÖ, Acu R, Yücel C, Cebeci S: Value of ultrasound elastography in the differential diagnosis of cervical lymph nodes: a comparative study with b-mode and color doppler sonography. J Ultrasound Med. 2016, 35:2491-9.

Alam F, Naito K, Horiguchi J, Fukuda H, Tachikake T, Ito K: Accuracy of sonographic elastography in the differential diagnosis of enlarged cervical lymph nodes: comparison with conventional B-mode sonography. AJR Am J Roentgenol. 2008;191:604-10.

Choi YJ, Lee JH, Baek JH. Ultrasound elastography for evalua-tion of cervical lymph nodes. Ultrasonography 2015 ;34(3):157-64.

Abdelgawad EA, Abu-samra MF, Abdelhay NM, Abdel-Azeem HM: B-mode ultrasound,color Doppler, and sonoelastography in differentiation between benign and malignant cervical lymph nodes with special emphasis on sonoelastography. Egypt J Radiol Nucl

Med. 2020;51: 10.

Lo WC, Cheng PW, Wang CT, Liao LJ. Real-time ultrasound elastography: an assessment of enlarged cervical lymph nodes. Eur Radiol 2013;23:2351–7.

Moharram MA, Abd-ElMaboud NM, Ahmed HA: Evaluation of the role of sono-elastography in diagnosis of enlarged cervical lymph nodes. Egypt J Radiol Nucl Med.2017, 48:381-91.

Ying M, Ahuja A, Brook F, Metreweli C. Sonographic features of normal cervical lymph nodes: variations with nodal size. Clin Radiol 2001;56:416–9.

Ahuja A, Ying M. Sonographic evaluation of cervical lymphadenopathy: is power Doppler sonography routinely indicated? Ultrasound Med Biol 2003;29 (3):353–9.

Desmots F, Fakhry N, Mancini J, Reyre A, Vidal V, Jacquier A, Santini L, Moulin G, Varoquaux A. Shear Wave Elastography in Head and Neck Lymph Node Assessment: Image Quality and Diagnostic Impact Compared with B-Mode and DopplerUltrasonography. Ultrasound Med Biol. 2016 Feb;42(2):387-98.

Wang, B.; Guo, Q.; Wang, J.-Y.; Yu, Y.; Yi, A.-J.; Cui, X.-W.; Dietrich, C.F. Ultrasound Elastography for the Evaluation of Lymph Nodes. Front. Oncol. 2021, 11, 3133.28.

Ozkan MB, Bilgici MC, Eren E, Caltepe G, Yilmaz G, Kara C, et al..Role of Point Shear Wave Elastography in the Determination of the Severity of Fibrosis in Pediatric Liver Diseases With Pathologic Correlations.JUltrasound Med: Off J Am Inst Ultrasound Med(2017)36(11):2337–44. 10.1002/jum.14277.

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Published

08-05-2025

How to Cite

Nazeer, N., Hameed, K., Imtiaz, S., Amber, S. tul, Irfan, B., & Sheikh, S. (2025). Diagnostic Accuracy of Sonoelastography for the diagnosis of of malignant cervical lymph nodes by taking histopathology as gold standard: Sonoelastography and malignant cervical nodes. Pakistan Journal of Radiology, 35(3). Retrieved from https://www.pakjr.com/index.php/PJR/article/view/1822