Examination of peripheral lymph nodes using shear wave elastography in patients with head and neck cancer
Between December and september 2018 123 patients with head and neck tumors underwent ultrasound examination. The median age of the patients was 57 years (range 19-76 years). Metastatic lymph nodes were suspected in all patients. A fine needle aspiration biopsy was performed prior to treatment. Aplio 500 (Toshiba, Japan) ultrasound device was used. According to findings of cytological examination, all patients were divided into 2 groups. Group I consisted of 58 patients with cytologically confirmed metastatic lymph nodes. Group II comprised 65 patients with lymphoid reticular hyperplasia. The values of Young's modulus for metastatic lymph nodes were: median - 134.2 kPa, 2.5-97.5 percentiles - 7.3-181.7 kPa. The corresponding values for hyperplastic lymph nodes were: 20.1 kPa, 6.9-138.3 kPa. Thus, significant differences in the values of Young's modulus between metastatic and hyperplastic lymph nodes were detected in patients with head and neck cancer (p<0.001). The best diagnostic values for detecting metastatic lymph nodes in patients with head and neck cancer were achieved with a threshold value of the Young's modulus of 33.2 kPa (sensitivity - 89.7 %, specificity - 84.6 %), AUC - 0.899. The values of the Young's modulus in the metastatic lymph nodes did not depend on the primary tumor and on the localization of the lymph nodes studied (submandibular, paratracheal, cervical, supraclavicular groups).