Virtual touch tissue imaging quantification shear wave elastography for determining benign versus malignant cervical lymph nodes: a comparison with conventional ultrasound

PURPOSE We aimed to prospectively examine virtual touch tissue imaging quantification (VTIQ) shear wave elastography (SWE) and conventional (B-mode and Doppler) ultrasonography (US), individually and combined, for their ability to differentiate benign and malignant cervical lymph nodes (CLNs). METHODS One hundred enlarged lymph nodes (LNs) from 72 patients, confirmed by histopathologic diagnoses, were included in the present study. B-mode US, Doppler US, and SWE were performed before histopathologic sampling of the LNs. The LN shear wave velocity (SWV, m/s) was assessed by VTIQ. RESULTS Using a 3.03 m/s cutoff value, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of SWVmax for differentiating benign and malignant CLNs were 93%, 59%, 68%, 91%, and 75%, respectively. B-mode and Doppler had a sensitivity, specificity, PPV, NPV, and accuracy of 79.2%, 71.2%, 71.6%, 78.7%, and 75%, respectively. B-mode, Doppler, and VTIQ SWE combined had 87.5%, 75%, 76.3%, 86.6%, and 81% for the same parameters, respectively. CONCLUSION VTIQ SWE is a promising noninvasive diagnostic imaging technique for differentiating benign and malignant CLNs. VTIQ SWV can improve the diagnostic performance of conventional US for differentiating benign and malignant CLNs.