Qualitative Classification of Shear Wave Elastography for Differential Diagnosis Between Benign and Metastatic Axillary Lymph Nodes in Breast Cancer
Qualitative Classification of Shear Wave Elastography for Differential Diagnosis Between Benign and Metastatic Axillary Lymph Nodes in Breast Cancer
复制标题
剪切波弹性成像的定性分类用于乳腺癌良性和转移性腋窝淋巴结的鉴别诊断
DOI：
10.3389/fonc.2019.00533
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发表时间：
2019-07-02
影响因子：
4.7
通讯作者：
Li, Yingjia
中科院分区：
文献类型：
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作者：
Luo, Shuyi;Yao, Guangyu;Li, Yingjia
目的：比较定性剪切波弹性成像（SWE）与常规超声（US）和定量SWE参数对腋窝淋巴结（ALN）状态评价的诊断性能。方法：共纳入118例患者，均为乳腺癌手术和粗针穿刺活检。活检前行常规超声和SWE检查。基于对每个ALN的定性评价，将SWE图像分为四种颜色模式：颜色模式1：均匀;颜色模式2：淋巴结（LN）内的充盈缺损;颜色模式3：LN内均匀，边缘有局部着色区域;颜色模式4：LN内充盈缺损，边缘有局部着色区域。比较了三种方法的诊断性能。结果：121例ALN中转移性淋巴结60例，良性淋巴结61例。良性ALNs多呈1型，而转移性ALNs多呈2 ~ 4型（P < 0.05）。SWE定性分级的AUC为0.983，高于SWE定量参数和常规超声（p<0.05）。最高的诊断性能，AUC为0.998，可以实现，如果传统的US和定性SWE应用。结论：在我们的研究中提出的定性SWE分类ALNs表现出更好的诊断性能比定量SWE参数和传统的US，特别是从良性反应ALNs转移性ALNs的区分。这种新的方法可以达到更准确的诊断，同时可以避免不必要的活检。
Purpose: To examine diagnostic performance of qualitative shear wave elastography (SWE) for evaluation of status of axillary lymph nodes (ALN) in comparison with conventional ultrasonograghy (US) and quantitative SWE parameters. Methods: A total of 118 patients were enrolled, who were all scheduled for breast cancer surgery and core needle biopsy. Conventional US and SWE were performed before biopsy. Based on qualitative evaluation of each ALN, the SWE images were classified into four color patterns: Color Pattern 1: homogeneous; Color Pattern 2: filling defect within lymph node (LN); Color Pattern 3: homogeneous within LN with a localized colored area at the margin; and Color Pattern 4: filling defect within LN with a localized colored area at the margin. The diagnostic performances of the three methods were compared. Results: There were 60 metastatic nodes and 61 benign nodes in the 121 ALNs. Benign ALNs were presented as Color Pattern 1 while metastatic ALNs usually were presented as Color Pattern 2 to 4 (p < 0.05). The AUC of qualitative SWE classification was 0.983, higher than that of quantitative SWE parameters and conventional US (p<0.05). The highest diagnostic performance, with AUC of 0.998, could be achieved if both conventional US and qualitative SWE were applied. Conclusion: The qualitative SWE classification of ALNs proposed in our study exhibited better diagnostic performance than quantitative SWE parameters and conventional US, especially for differentiating metastatic ALNs from benign reactive ALNs. More accurate diagnosis could be reached with this new method and unnecessary biopsy might be avoided in the meantime.