{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:05:07Z","timestamp":1791378307927,"version":"4.3.2"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the diagnostic efficiency and diagnostic threshold of conventional US and shear-wave elastography (SWE) in superficial enlarged lymph nodes (LNs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 204 patients with superficial enlarged LNs were enrolled in this retrospective study aged 46.0 \u00b1 15.2 years from March 2020 to March 2021. LNs with a long axis larger than 0.7\u00a0cm were considered as superficial enlarged. Before the histological biopsy, LNs that were considered suspicious according to both conventional US and SWE were included, while LNs with no or unclear pathological results, or with no satisfactory SWE images, were excluded. The conventional and 2-D SWE examinations were performed with Aplio i800 and Acuson sequoia equipped with i18LX5 linear-array transducer (5-18 MHz) and 10L4 linear-array transducer (4-10 MHz), respectively. Both E Median and Vs Median parameters were investigated by two senior ultrasound physicians. The pathological results were performed as the gold standard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Variables including transverse axis size, lymphatic hilum, L\/T ratio, echogenicity, and color Doppler pattern were considered significant. The mean E Median value in benign, metastatic LNs, and lymphoma were 28.26 \u00b1 8.87 kPa, 77.46 \u00b1 22.85 kPa, and 50.37 \u00b1 5.41 kPa (<jats:italic>p &amp;lt;<\/jats:italic>0.001), while Vs Median values were 3.02 \u00b1 0.50\u00a0m\/s, 4.87 \u00b1 0.90\u00a0m\/s, and 4.09 \u00b1 0.22\u00a0m\/s, respectively (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). The diagnostic performance indicated the high sensitivity, specificity, PPV, NPV, and overall accuracy of conventional US combined with SWE. The optimal cutoff values of E Median and Vs Median for predicting malignant LNs were 42.90 kPa and 3.73\u00a0m\/s, respectively. As AUC value, sensitivity, specificity, accuracy, PPV, and NPV revealed, the indexes of E Median were 0.976, 0.927, 0.975, 0.946, 0.983, and 0.897, respectively, while Vs Median were 0.970, 0.927, 0.963, 0.941, 0.975, and 0.895, respectively (<jats:italic>p &amp;lt;<\/jats:italic>0.001). The ROC curves of both E Median (AUC=0.976) Vs Median (AUC=0.970) suggested the remarkable diagnostic efficiency in distinguishing benignity between suspected malignant LNs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Above results indicated that conventional US together with 2-D SWE could elevate the diagnostic performance. Meanwhile, the parameters of 2-D SWE including E Median and Vs Median could effectively assess malignant LNs, which provide valuable differentiating information in superficial enlarged LNs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2022.908085","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T10:37:48Z","timestamp":1656585468000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Differential Diagnosis Value of Shear-Wave Elastography for Superficial Enlarged Lymph Nodes"],"prefix":"10.3389","volume":"12","author":[{"given":"Yanjuan","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengrong","family":"Mi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.714660","article-title":"Ultrasound Elastography for the Evaluation of Lymph Nodes","volume":"11","author":"Bin","year":"2021","journal-title":"Front Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14998","article-title":"Ultrasound Imaging for Detecting Metastasis to Level II and III Axillary Lymph Nodes After Axillary Lymph Node Dissection for Invasive Breast Cancer","volume":"38","author":"Xi","year":"2019","journal-title":"J Ultrasound Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-07958-y","article-title":"Ultrasound Lymphatic Imaging for the Diagnosis of Metastatic Central Lymph Nodes in Papillary Thyroid Cancer","volume":"31","author":"Liu","year":"2021","journal-title":"Eur Radiol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-020-02407-6","article-title":"Correlation Between the Contrast-Enhanced Ultrasound Image Features and Axillary Lymph Node Metastasis of Primary Breast Cancer and Its Diagnostic Value","volume":"23","author":"Xu","year":"2021","journal-title":"Clin Transl Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-016-4378-3","article-title":"The Diagnostic Performance of Shear Wave Elastography for Malignant Cervical Lymph Nodes: A Systematic Review and Meta-Analysis","volume":"27","author":"Suh","year":"2017","journal-title":"Eur Radiol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1055\/a-0838-9937","article-title":"The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018","volume":"40","author":"S\u0103ftoiu","year":"2019","journal-title":"Ultraschall Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.ultrasmedbio.2016.06.022","article-title":"WFUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography: Part 4. 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