Diagnostic performance of shear wave elastography and diffusion-weighted magnetic resonance imaging in cervical lymph nodes: a comparative study

Background/aim: To investigate the potential diagnostic value of point shear wave elastography (pSWE) and the contribution of concurrent diffusion weighted magnetic resonance imaging (DW-MRI) to diagnostic performance in patients with cervical lymphadenopathy. Materials and methods: This cross-sectional study included 116 cervical lymph nodes of 94 patients. All lymph nodes were evaluated before the treatment or histopathological sampling. Gray scale ultrasonographic features, elastographic stiffness and apparent diffusion coefficient (ADC) values were measured and recorded. Lymph nodes were divided into benign and malignant groups with histopathological findings. Results: Short axis measurement, axis ratio, hilum morphology, vascularization patterns, pSWE, and ADC values were the most significant parameters in logistic regression tests. The median stiffness of malignant nodes was higher and the mean ADC values were lower than others. Also, lymphoproliferative disorders had the lowest ADC values (p < 0.001). Area under the curve values for pSWE and DW-MRI were 0.852 [95% confidence interval (CI), 0.779­0.925], 0.790 (95% CI, 0.695­0.885), respectively. The accuracy rate increased from 79.3% to 85.3% when the pSWE was combined with the ultrasonography (US). Conclusion: The use of pSWE combined with conventional US will reduce the number of biopsies and may be sufficient to differentiate the lymph nodes.