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The diagnostic performance of shear wave elastography for malignant cervical lymph nodes: A systematic review and meta-analysis

Abstract

Objective

To evaluate the diagnostic performance of shear wave elastography for malignant cervical lymph nodes.

Methods

We searched the Ovid-MEDLINE and EMBASE databases for published studies regarding the use of shear wave elastography for diagnosing malignant cervical lymph nodes. The diagnostic performance of shear wave elastography was assessed using bivariate modelling and hierarchical summary receiver operating characteristic modelling. Meta-regression analysis and subgroup analysis according to acoustic radiation force impulse imaging (ARFI) and Supersonic shear imaging (SSI) were also performed.

Results

Eight eligible studies which included a total sample size of 481 patients with 647 cervical lymph nodes, were included. Shear wave elastography showed a summary sensitivity of 81 % (95 % CI: 72–88 %) and specificity of 85 % (95 % CI: 70–93 %). The results of meta-regression analysis revealed that the prevalence of malignant lymph nodes was a significant factor affecting study heterogeneity (p < .01). According to the subgroup analysis, the summary estimates of the sensitivity and specificity did not differ between ARFI and SSI (p = .93).

Conclusion

Shear wave elastography is an acceptable imaging modality for diagnosing malignant cervical lymph nodes. We believe that both ARFI and SSI may have a complementary role for diagnosing malignant cervical lymph nodes.

Key Points

Shear wave elastography is acceptable modality for diagnosing malignant cervical lymph nodes.

Shear wave elastography demonstrated summary sensitivity of 81 % and specificity of 85 %.

ARFI and SSI have complementary roles for diagnosing malignant cervical lymph nodes.

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Abbreviations

US:

Ultrasound

ARFI:

Acoustic radiation force impulse imaging

SSI:

Supersonic shear imaging

VTIQ:

Virtual touch tissue imaging quantification

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Acknowledgments

The scientific guarantor of this publication is Young Jun Choi. The authors of this manuscript declare that they have or had no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work did not receive any financial funding. One of the authors (Chong Hyun Suh) has significant statistical expertise. Neither Institutional Review Board approval nor written informed consent was required for this study due to the nature of our study which was a systemic review and meta-analysis. Methodology: Meta-analysis performed at one medical institution.

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Suh, C.H., Choi, Y.J., Baek, J.H. et al. The diagnostic performance of shear wave elastography for malignant cervical lymph nodes: A systematic review and meta-analysis. Eur Radiol 27, 222–230 (2017). https://doi.org/10.1007/s00330-016-4378-3

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  • DOI: https://doi.org/10.1007/s00330-016-4378-3

Keywords

  • Malignant cervical lymph nodes
  • Ultrasound
  • Shear wave elastography
  • Acoustic radiation force impulse imaging
  • Supersonic shear imaging