Abstract:

Objective To evaluate the value of real-time tissue elastography (RTE) for the differential diagnosis of axillary lymph nodes of patients with breast cancer. Methods Sixty-nine axillary lymph nodes of patients with breast cancer underwent grey-scale ultrasound and RTE. The grey-scale sonograms and elastograms were scored from 1 to 5. The region of interest of elastogram scoring is the hypoechoic region in the lymph nodes. The combined score was the sum of both grey-scale and elastogram scores. The strain ratio (SR) index was also measured. Results of RTE were compared to the pathological results of the lymph node core biopsy. Results According to the ROC curve, the diagnostic cutoff value of grey-scale ultrasound and RTE scores was 3; combined evaluation was 6; and SR was 2.28. Sensitivity, specificity, and diagnostic accuracy of grey-scale sonography were 89.74%, 76.67%, and 84.06% and those of RTE were 84.61%, 90.00% and 87.96%. Sensitivity, specificity, and diagnostic accuracy of combined evaluation were 92.31%, 93.33% and 92.75%, and those of SR were 94.87%, 83.33% and 89.86%. Conclusion RTE is a complementary method of the grey-scale ultrasound for the differential diagnosis of axillary lymph nodes of patients with breast cancer.

Key words: ultrasound, real-time tissue elastography, breast cancer, axillary lymph node metastasis