Multiparametric Ultrasound Evaluation of Axillary Lymph Nodes in Breast Cancer Patients

Öz

This study aims to evaluate benign and malignant axillary lymph nodes (LN) in breast cancer using multiparametric ultrasound (US). The morphological characteristics, stiffness, and VI differences between 52 benign and malignant LNs were statistically evaluated using B-mode US, shear wave elastography (SWE), and superb microvascular imaging (SMI) before biopsy. Significant cutoff values were determined using receiver operating characteristic (ROC) curve analysis. Malignant lymph nodes had higher short-axis diameters (SD), lower long-axis diameter/short axis diameter ratios (LD/SD), and increased cortical thickness (p=0.026, p=0.044, p=0.004, p=0.000, respectively). A cortical thickness above 3.1 mm (AUC: 0.751, sensitivity: 94.1%, specificity: 51.4%, p=0.0003), SD greater than 8.4 mm (AUC: 0.692, sensitivity: 41.1%, specificity: 91.4%, p= 0.0141), LD/SD ≤2 (AUC: 0.664, sensitivity: 76.5%, specificity: 48.6%, p=0.0355) and, a mean elasticity value above 26.2 kPa (AUC: 0.861, sensitivity: 70.6%, specificity: 91.4%, p<0.0001) were identified as the best cutoff values for detecting metastasis. Since multiparametric ultrasound provides valuable information for detecting metastatic lymph nodes, we recommend multiparametric assessment rather than B-mode ultrasound alone.

Anahtar Kelimeler

• breast cancer
• axillary lymph node
• multiparametric ultrasound
• shear wave elastography (SWE)
• superb microvascular imaging (SMI)

Meme Kanserli Hastalarda Aksiller Lenf Nodlarının Çok Parametreli Ultrason İle Değerlendirmesi

Öz

Bu çalışma, meme kanserli hastalarda çok parametreli Ultrason (US) ile benign ve malign aksiller lenf nodlarını (LN) değerlendirmeyi amaçlamaktadır. Elli iki lenf nodunun morfolojik özellikleri, sertlik ve vasküler indeks (VI) değerleri, biyopsi öncesinde B-mod US, shear wave elastografi (SWE) ve superb microvascular imaging (SMI) teknikleri ile istatistiksel olarak değerlendirildi. Anlamlı cutoff değerler, receiver operating characteristic (ROC) eğri analizi kullanılarak tespit edildi. Malign LN'ları benign LN'larına kıyasla, daha yüksek kısa-aks değerine (KD), daha düşük uzun/kısa-aks oranlarına (UD/KD) ve artmış kortikal kalınlığa sahipti (sırasıyla p=0,026, p=0,044, p=0,004, p=0,000). 3,1 mm'nin üzerindeki kortikal kalınlık (AUC: 0,751, duyarlılık: %94,1, özgüllük: %51,4, p=0,0003), 8,4 mm'nin üzerindeki KD (AUC: 0,692, duyarlılık: %41,1, özgüllük: %91,4, p= 0,0141), ≤2 UD/KD (AUC: 0,664, duyarlılık: %76,5, özgüllük: 48,6%, p=0,0355) ve 26,2 kPa'nın üzerinde ortalama elastikiyet değeri (AUC: 0,861, duyarlılık: 70,6%, özgüllük: 91,4%, p<0,0001) metastazı tespit etmek için en iyi cutoff değerler olarak belirlendi. Multiparametrik US ile lenf nodlarının değerlendirilmesi tanı ve tedavinin belirlenmesinde değerli bilgiler sağlamaktadır. Bu nedenle tek başına B-mod US inceleme yerine multiparametrik US değerlendirmeyi önermekteyiz.

Anahtar Kelimeler

• meme kanseri
• çok parametreli ultrason
• shear wave elastografi (SWE)
• superb microvascular imaging (SMI)

Kaynakça

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