Virtual Touch Tissue Imaging Quantification Shear Wave Elastography: Prospective Assessment of Cervical Lymph Nodes

Abstract

The goal of this study was to prospectively evaluate the diagnostic performance of Virtual Touch tissue imaging quantification (VTIQ) shear wave elastography in the discrimination of benign and malignant cervical lymph nodes in routine clinical practice. Shear wave velocity was analyzed using VTIQ in 100 patients with 100 histologically proven cervical lymph nodes. Diagnostic performance was evaluated using receiver operating characteristic curve analysis and leave-one-out cross-validation. Agreement between measurements was assessed with intra-class correlation coefficients. The mean shear wave velocity was significantly higher in metastatic lymphadenopathy (4.46 ± 1.46 m/s) than in benign lymphadenopathy (2.71 ± 0.85 m/s) (p < 0.001) at a cutoff level of 3.34 m/s. The cross-validated accuracy, sensitivity and specificity were 77%, 78.9% and 74.4%, respectively. Agreement of measurements with VTIQ was excellent (intra-class correlation coefficient = 0.961). VTIQ shear wave elastography may be a feasible quantitative imaging method for differentiating benign and malignant cervical lymph nodes.

Keywords: Head and neck; Lymph nodes; Malignant; Shear wave elastography; Ultrasound; Virtual Touch tissue imaging quantification.