Real-Time Tissue Elastography for the Diagnosis of Lymph Node Metastasis in Oral Squamous Cell Carcinoma

• Published in: Ultrasound in medicine & biology Vol. 38; no. 3; pp. 389 - 395
• Main Authors: Ishibashi, Naomi, Yamagata, Kenji, Sasaki, Hiroyoshi, Seto, Kahori, Shinya, Yoshiko, Ito, Hiroyuki, Shinozuka, Keiji, Yanagawa, Toru, Onizawa, Kojiro, Bukawa, Hiroki
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2012; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - secondary; Computer Systems; Diagnosis; Elasticity Imaging Techniques - methods; Elastography; Female; Hematologic and hematopoietic diseases; Humans; Investigative techniques, diagnostic techniques (general aspects); Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; LN metastasis; Lymph Nodes - diagnostic imaging; Lymphatic Metastasis; Male; Medical sciences; Middle Aged; Miscellaneous. Technology; Mouth Neoplasms - diagnostic imaging; Oral cancer; Radiology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Reproducibility of Results; Sensitivity and Specificity; Ultrasonic investigative techniques; Ultrasonography; Diagnosis; Oral cancer; LN metastasis; Elastography; Ultrasonography; Sonography; Nuclear medicine; Stomatology; Malignant lymphadenopathy; Malignant hemopathy; Malignant tumor; Oral squamous cell carcinoma; Lymph node metastasis; Echography; Radiology; Oral cavity disease; Cancer; Biomedical engineering
• ISSN: 0301-5629; 1879-291X
• DOI: 10.1016/j.ultrasmedbio.2011.12.004

Abstract We compared conventional ultrasound (US) B-mode, color Doppler and elastographic assessment of lymph node (LN) stiffness against pathological findings from surgical samples, to determine the most useful factors for identifying LN metastases. Seventy-one LNs in 19 patients with oral squamous cell carcinoma (OSCC) were examined. Using our new system, elastography images were scored from 1–5. The score 1–4 were correlated with the blue area of each LN, which indicated increased stiffness: (1) none; (2) <50%; (3) 50%; or (4) >50%. A score 5 indicated central necrosis and did not correlate with the blue area. We found significant differences in minimal diameter, shape index, margin, internal structure, hilus presence or absence, elastography score and percentage of blue area between metastatic and nonmetastatic LNs. Stepwise regression analysis identified elastography score 3–5 as an independent significant LN metastatic factor, suggesting that our scoring system may be useful for accurately diagnosing metastatic LNs.