Diagnostic Performance of Superb Microvascular Imaging in Differentiating Benign and Malignant Axillary Lymph Nodes

Kurt S. A., Eryurekli A. E., KAYADİBİ Y., SAMANCI C., VELİDEDEOĞLU M., ONUR İ., ...Daha Fazla

Ultrasound Quarterly, cilt.39, sa.2, ss.74-80, 2023 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 39 Sayı: 2
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1097/ruq.0000000000000617
  • Dergi Adı: Ultrasound Quarterly
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, MEDLINE
  • Sayfa Sayıları: ss.74-80
  • Anahtar Kelimeler: AUC = area under curve, axillary lymph node, DCIS = ductal carcinoma in situ, FNA = fine needle aspiration, LN = lymph node, metastasis, PDUS = power Doppler ultrasound, ROC = receiver operator characteristic, ROI = region of interest, SMI = superb microvascular imaging, superb microvascular imaging, ultrasonography, Doppler, US = ultrasound, VI = vascular index
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

The aim was to evaluate the effectiveness of superb microvascular imaging (SMI) in axillary lymph nodes (LNs). Benign and malignant LNs diagnosed via histopathological examination constituted the study subgroups. In addition to grayscale findings for morphological evaluation, vascular patterns and appearance of internal vessels were analyzed by both power Doppler ultrasound (PDUS) and SMI. The number of vascular branches was counted, and a vascularity index (VI) was calculated by SMI. Fifty-two LNs with suspicious findings in terms of metastasis (33 malignant and 19 benign) were evaluated. Diagnostic accuracy according to vascular patterns was 82% for PDUS and 92% for SMI. In the presence of asymmetric cortical thickening, there was a significant difference between benign and malignant LNs in the number of vascular branches of both thin and thick cortical sides (P < 0.01). Mean VI was significantly higher in the malignant group (P < 0.05). In differentiating malignancy, when a cutoff VI value was set to 9%, sensitivity was 69.7%, and specificity was 63.2%. Evaluating the vascularity of axillary LNs by SMI is a useful tool in determining the potential of axillary metastasis, especially in the absence of typical sonographic findings. Superb microvascular imaging can beneficially be used to select the most suspicious LN and suspicious area of the LN to sample.