Shear wave elastography and elastometry in the differential diagnosis of metastatic parasternal lymphatic collector in patients with breast cancer


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Abstract

Objective. To improve the effectiveness of diagnosing metastatic parasternal lymph nodes. Materials and methods. The study included 55 women diagnosed with breast cancer during the period from 2017 to 2019. Results. The patients were divided into two groups: 24 patients with metastatic lesions and 31 patients with lymphoid hyperplasia. The average shear wave velocity in the lymph node was 2.14 (0.77) cm/s in patients with lymphoid hyperplasia, it was 3.13 (1.09) cm/s in case of metastatic lesions and 2.26 (0.71) cm/s in the surrounding tissues. Shear wave velocity in metastasis was higher (p<0.0001) than one in the lymph node hyperplasia and in the surrounding tissues. The optimal threshold value was 2.385 m/s. Elastometry was informative with the following indicators: sensitivity - 77.4%; specificity - 66.7%; positive prognostic value - 75.0%; negative prognostic value - 69.6%. Elastography showed that hard consistency was characteristic of 23 (95.8%) metastatic lymph nodes, and soft consistency was in one (4.2%) case. Elastometry showed hard consistency of hyperplasia in 7 (28.0%) cases, and soft consistency in 18 (72.0%) cases. Elastography was informative with the following indicators: sensitivity - 77.3%, specificity - 69.7%, positive prognostic value - 63.0%, negative prognostic value - 82.1%. Conclusion. Comprehensive ultrasound examination of the lymph nodes, including shear wave elastography and elastometry can increase informative value of the standard ultrasound examination.

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About the authors

Vyacheslav M. Snitkin

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: snitkinvm@yandex.ru
post-graduate student of the Department of ultrasound diagnostics of the Research Institute of Clinical and Experimental Radiology

Alina V. Samoukina

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: neurol5doc@yandex.ru
post-graduate student of the oncological department of surgical methods of treatment No. 13, Institute of Clinical Oncology

Nafset D. Khakurinova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: nafset270l@mail.ru
Oncologist, Department of the day hospital (chemotherapeutic and surgical methods of treatment)

Vladimir N. Sholokhov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: vnshell@mail.ru
MD, Professor, leading researcher of the Department of ultrasound diagnostics of the Research Institute of Clinical and Experimental Radiology

Yuri S. Sergeev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: info@ronc.ru
PhD., associate professor of the Department of Oncology, Institute of Clinical Medicine named after N.V. Sklifosovsky

Dmitry E. Avtomonov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: info@ronc.ru
PhD., assistant of the Department of Oncology, Institute of Clinical Medicine named after N.V. Sklifosovsky

Ramiz K. Valiev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: info@ronc.ru
PhD., Head of the Oncological Department of surgical methods of treatment No. 13, Research Institute of Clinical Oncology

Alexander V. Petrovsky

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: alexpetrovsky@hotmail.com
PhD, deputy director for the development of cancer care in the regions, Research Institute of Clinical Oncology

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