The benefit of superb microvascular imaging and shear wave elastography in differentiating metastatic axillary lymphadenopathy from lymphadenitis.

PURPOSE: The purpose of this study is to detect and compare the diagnostic performances of vascularity index (VI) via superb microvascular imaging (SMI) and shear wave elastography (SWE) in metastatic axillary lymphadenopathy and lymphadenitis. MATERIALS AND METHODS: The study is based on 45 female patients who were ultrasonographed due to swelling in the axilla and underwent SWE and SMI before tru-cut biopsy, between August 2019 and February 2021. The patients had a total of 53 lymph nodes (LNs), 38 of these were metastatic and 15 were lymphadenitis. RESULTS: The results showed that mean volumes, value of cortex thickness, elasticity and velocity values, and mean VI values were significantly higher in metastatic LAP group compared to lymphadenitis group. Correlation analysis showed that both VI (r: 0.44) and elastography (r: 0.52) values were positively correlated with the cortex thickness, while elastography values were strongly correlated with volume (r: 0.42) and short diameter (r: 0.40). For differentiating lymphadenitis and metastatic LAP, the optimal cut-off VI value was 8.55 while the optimal cut-off elastography value was 31.8 kPa. CONCLUSION: In conclusion, combined grayscale ultrasonography evaluation of lymph nodes with SWE and SMI increase the diagnostic performance in distinguishing lymphadenitis-metastatic LAP.