The diagnostic value of two-dimensional shear-wave elastography in identifying malignant lesions in lymph nodes: a prospective study

Abstract This study evaluates the diagnostic performance of two-dimensional shear wave elastography (2D-SWE) in differentiating between benign, metastatic lymph nodes (LNs) and lymphomas. From May 2022 to February 2023, a total of 137 patients who presented with unexplained LN enlargement were exami...

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Main Authors: Jing Chen, Yao Deng, Jiajia Xiong, WenQu Li, Gongqun Shang, Hui Li, Yu Wu, Xiaojuan Qin
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-00502-8
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author Jing Chen
Yao Deng
Jiajia Xiong
WenQu Li
Gongqun Shang
Hui Li
Yu Wu
Xiaojuan Qin
author_facet Jing Chen
Yao Deng
Jiajia Xiong
WenQu Li
Gongqun Shang
Hui Li
Yu Wu
Xiaojuan Qin
author_sort Jing Chen
collection DOAJ
description Abstract This study evaluates the diagnostic performance of two-dimensional shear wave elastography (2D-SWE) in differentiating between benign, metastatic lymph nodes (LNs) and lymphomas. From May 2022 to February 2023, a total of 137 patients who presented with unexplained LN enlargement were examined at the Ultrasound Medical Department of Union Hospital of Huazhong University of Science and Technology. The conventional ultrasound recorded the location, longitudinal diameter, transverse diameter, L/T ratio, blood supply mode, lymphatic hilum and 2D-SWE calculated the average elasticity (E) of LN. Histopathology was the diagnostic gold standard. A total of 124 patients with 159 superficial LNs were included (32 benign, 70 metastatic, 57 lymphoma). Malignant LNs had significantly higher E values than benign ones (49.38 ± 29.96 kPa vs. 25.00 ± 14.42 kPa, P < 0.001). When E > 25.46 kPa, the AUC, sensitivity, specificity, PPV, NPV and accuracy were 0.807, 0.787, 0.750, 0.926, 0.471 and 0.780, respectively, in identifying malignant LNs. For distinguishing benign LNs from lymphoma, the E cutoff was 25.03 kPa, with the AUC, sensitivity, specificity, PPV, NPV and accuracy of 0.727, 0.754, 0.719, 0.827, 0.622 and 0.742, respectively. To differentiate benign from metastatic LNs, an E cutoff of 36.97 kPa yielded an AUC, sensitivity, specificity, PPV, NPV and accuracy of 0.872, 0.757, 0.875, 0.930, 0.622 and 0.794, respectively. Comparing lymphoma and metastatic LNs, the E cutoff was 42.57 kPa. And the AUC, sensitivity, specificity, PPV, NPV and accuracy were 0.787, 0.700, 0.860, 0.860, 0.700 and 0.772, respectively. 2D-SWE parameter (the average elasticity) can effectively evaluate benign, metastatic LNs and lymphoma, which provides valuable information for preoperative evaluation of superficial LNs.
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spelling doaj-art-0301ac61d60a4e91b5a643af34f8604b2025-08-20T03:08:25ZengNature PortfolioScientific Reports2045-23222025-05-0115111110.1038/s41598-025-00502-8The diagnostic value of two-dimensional shear-wave elastography in identifying malignant lesions in lymph nodes: a prospective studyJing Chen0Yao Deng1Jiajia Xiong2WenQu Li3Gongqun Shang4Hui Li5Yu Wu6Xiaojuan Qin7Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract This study evaluates the diagnostic performance of two-dimensional shear wave elastography (2D-SWE) in differentiating between benign, metastatic lymph nodes (LNs) and lymphomas. From May 2022 to February 2023, a total of 137 patients who presented with unexplained LN enlargement were examined at the Ultrasound Medical Department of Union Hospital of Huazhong University of Science and Technology. The conventional ultrasound recorded the location, longitudinal diameter, transverse diameter, L/T ratio, blood supply mode, lymphatic hilum and 2D-SWE calculated the average elasticity (E) of LN. Histopathology was the diagnostic gold standard. A total of 124 patients with 159 superficial LNs were included (32 benign, 70 metastatic, 57 lymphoma). Malignant LNs had significantly higher E values than benign ones (49.38 ± 29.96 kPa vs. 25.00 ± 14.42 kPa, P < 0.001). When E > 25.46 kPa, the AUC, sensitivity, specificity, PPV, NPV and accuracy were 0.807, 0.787, 0.750, 0.926, 0.471 and 0.780, respectively, in identifying malignant LNs. For distinguishing benign LNs from lymphoma, the E cutoff was 25.03 kPa, with the AUC, sensitivity, specificity, PPV, NPV and accuracy of 0.727, 0.754, 0.719, 0.827, 0.622 and 0.742, respectively. To differentiate benign from metastatic LNs, an E cutoff of 36.97 kPa yielded an AUC, sensitivity, specificity, PPV, NPV and accuracy of 0.872, 0.757, 0.875, 0.930, 0.622 and 0.794, respectively. Comparing lymphoma and metastatic LNs, the E cutoff was 42.57 kPa. And the AUC, sensitivity, specificity, PPV, NPV and accuracy were 0.787, 0.700, 0.860, 0.860, 0.700 and 0.772, respectively. 2D-SWE parameter (the average elasticity) can effectively evaluate benign, metastatic LNs and lymphoma, which provides valuable information for preoperative evaluation of superficial LNs.https://doi.org/10.1038/s41598-025-00502-8UltrasoundShear-wave elastographySuperficial lymph nodesDifferential diagnosis
spellingShingle Jing Chen
Yao Deng
Jiajia Xiong
WenQu Li
Gongqun Shang
Hui Li
Yu Wu
Xiaojuan Qin
The diagnostic value of two-dimensional shear-wave elastography in identifying malignant lesions in lymph nodes: a prospective study
Scientific Reports
Ultrasound
Shear-wave elastography
Superficial lymph nodes
Differential diagnosis
title The diagnostic value of two-dimensional shear-wave elastography in identifying malignant lesions in lymph nodes: a prospective study
title_full The diagnostic value of two-dimensional shear-wave elastography in identifying malignant lesions in lymph nodes: a prospective study
title_fullStr The diagnostic value of two-dimensional shear-wave elastography in identifying malignant lesions in lymph nodes: a prospective study
title_full_unstemmed The diagnostic value of two-dimensional shear-wave elastography in identifying malignant lesions in lymph nodes: a prospective study
title_short The diagnostic value of two-dimensional shear-wave elastography in identifying malignant lesions in lymph nodes: a prospective study
title_sort diagnostic value of two dimensional shear wave elastography in identifying malignant lesions in lymph nodes a prospective study
topic Ultrasound
Shear-wave elastography
Superficial lymph nodes
Differential diagnosis
url https://doi.org/10.1038/s41598-025-00502-8
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