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. 2018 Dec 7;8(1):17708.
doi: 10.1038/s41598-018-34806-9.

Ultrasonography for lymph nodes metastasis identification in bitches with mammary neoplasms

Priscila Silva  1 , Ricardo Andres Ramirez Uscategui  2   3 , Marjury Cristina Maronezi  1 , Beatriz Gasser  4 , Letícia Pavan  4 , Igor Renan Honorato Gatto  4 , Vivian Tavares de Almeida  1 , Wilter Ricardo Russiano Vicente  4 , Marcus Antônio Rossi Feliciano  1   5
Affiliations

Ultrasonography for lymph nodes metastasis identification in bitches with mammary neoplasms

Priscila Silva et al. Sci Rep. .

Abstract

The aim of this study was to evaluate and compare the diagnostic accuracy of B-mode, Doppler ultrasonography and Acoustic Radiation Force Impulse (ARFI) elastography in the identification of axillary and inguinal lymph nodes metastasis in bitches with mammary neoplasms. The axillary (n = 96) and inguinal (n = 100) lymph nodes of 100 bitches were evaluated using B-Mode, Colour Doppler and ARFI-elastography. After this evaluation, mastectomy and lymph nodes excision were performed and these structures were histologically classified as free, reactive or metastatic. Ultrasonographic parameters were compared by Chi-Square or ANOVA tests and if they are significant, discriminative power analysis according to histopathological classification was performed (ROC analysis). The ARFI-elastography shear wave velocity (SWV) enabled metastasis identification in inguinal (sensitivity 95% specificity 87%) and axillary lymph nodes (sensitivity 100% specificity 94%). While B-Mode ultrasound Short/Long axis ratio evaluation of inguinal and axillary lymph nodes only resulted in a sensitivity around of 71% and specificity of 55%. In conclusion, B-Mode ultrasonography may contribute to diagnosis of metastasis in axillary and inguinal lymph nodes of bitches affected by mammary neoplasm with limited accuracy, while SWV evaluation proved to be an excellent diagnosis tool, which allows differentiation between free, reactive and tumour metastatic lymph nodes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
B-Mode ultrasound images of a canine loco regional lymph nodes. (A) inguinal lymph node with metastasis note the elongated shape. (B) normal inguinal lymph node. (C) axillary lymph node with metastasis note the rounded shape. (D) normal axillary lymph node.
Figure 2
Figure 2
Colour Doppler ultrasound images of canine loco regional lymph nodes. (A) Normal axillary lymph node with absence of vascularization. (B) Axillary lymph node with metastasis and presence of neovascularization, (C) normal inguinal lymph node with absence of vascularization and (D) inguinal lymph node with metastasis and presence of neovascularization.
Figure 3
Figure 3
Qualitative and quantitative ARFI-elastography images of (A) normal axillary lymph node, (B) normal inguinal lymph node with homogeneous pattern and SWV in m/s. (C) Reactive axillary lymph node, (D) reactive inguinal lymph node with heterogeneous pattern and SWV in m/s. (E) Axillary lymph node with metastasis, (F) inguinal lymph node with metastasis with heterogeneous pattern and SWV in m/s.
Figure 4
Figure 4
ROC (Receiving Operating Characteristic) curves that compare the predictive sensitivity % and 100% – specificity % of different ultrasound methods for determination of metastasis in (A) inguinal and (B) axillary lymph nodes of bitches affected by mammary neoplasms using the histopathological classification as reference. * indicate significant difference (P < 0.01).
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