Prospective analysis of mapped cervical lymph nodes to identify sonographically detectable intranodal microchanges by elastography-an interim status

Introduction This study examines whether elastography in combination with conventional sonography can contribute to the detection of microchanges of cervical lymph nodes (LN). The reproducibility of elastography is often criticized which is why the examinations are performed by 2 investigators on 2 different devices.

Material/method prospective, monocentric; inclusion study group [S]: unclear lymphadenopathy with indication for LN extirpation; cN0/cN+; age>18.

Exclusion no ability to operate; ECOG>2. Examination of the LN [GE LOGIQ E9 + Mindray Resona 7] by B-scan, duplex, strain (SE) and shear wave elastography (SWE); sonographic and histological subdivision of the LN into 4 quadrants. Histology analogous to routine (conspicuous LN) or as sentinel (inconspicuous LN). Control group [K]: blanched/inflammatory reactive LN. Definition of suspicious LN: >30 kPa or >3 m/s.

Results From 07/22 to 04/23, min n=20 [S] + n=20 [K] LN are examined. So far, 11 LN (7 patients) [S] and 18 LN (14 patients) [K] were examined. 5 benign [b] and 6 malignant [m] LN were identified histopathologically. The Solbiati index was 2.75 (1.7 – 3.5) [Sb] and 1.67 (1.22 – 2) [Sm]. SWE results for b/m LN averaged 26.2/52.3 kPa for GE and 18.2/59.6 kPa for Mindray and 2.8/3.8 m/s for GE and 2.4/4.2 m/s for Mindray, respectively. At one LN [S] detection of a metastasis by SWE (3 quadrants normative, one quadrant at 2.9 m/s (GE) and 3.6 m/s (Mindray) was successfully.

Discussion Interim analysis indicates that elastography in combination with B-scan and duplex sonography can detect even the smallest metastases. As expected, there are device-specific differences that need to be further classified in the final analysis.

Publication History

Article published online:
12 May 2023