Shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma

Objectives: To evaluate shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma. Methods: 77 patients with oral squamous cell carcinoma were examined by B-mode and shear wave elastography with a 14 MHz linear transducer. The integrated shear wave elastography software allowed the operator to place regions of interest of various sizes within the elastography window, and automatically displayed shear elastic modulus data (kPa) for each region of interest. The relationship between size and shear elastic modulus of cervical lymph nodes was assessed by Pearson's rank correlation test. The shear elastic modulus of cervical lymph nodes in benign and malignant were evaluated using the Mann-Whitney U test. The analyses were used with a 5% significance level. Results: We plotted shear elastic modulus (X) against minimal axial diameter of cervical lymph nodes (Y), and observed a significant correlation [Y= 0.091 X + 4.648 (R-2 = 0.603,p = 0.000, N = 77)]. Furthermore, the shear elastic modulus of the malignant cervical lymph nodes (105.9 +/- 5.2 kPa) was higher than that of benign (11.9 +/- 4.4 kPa, p = 0.000). Conclusions: The shear wave elastography is an effective technique for the objectively and quantitatively diagnosis of cervical lymph node metastases of the oral carcinoma.