Ex vivo shear-wave elastography of axillary lymph nodes to predict nodal metastasis in patients with primary breast cancer

Soong June Bae, Jong Tae Park, Ah Young Park, Ji Hyun Youk, Jong Won Lim, Hak Woo Lee, Hak Min Lee, Sung Gwe Ahn, Eun Ju Son, Joon Jeong

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: There is still a clinical need to easily evaluate the metastatic status of lymph nodes during breast cancer surgery. We hypothesized that ex vivo shear-wave elastography (SWE) would predict precisely the presence of metastasis in the excised lymph nodes. Methods: A total of 63 patients who underwent breast cancer surgery were prospectively enrolled in this study from May 2014 to April 2015. The excised axillary lymph nodes were examined using ex vivo SWE. Metastatic status was confirmed based on the final histopathological diagnosis of the permanent section. Lymph node characteristics and elasticity values measured by ex vivo SWE were assessed for possible association with nodal metastasis. Results: A total of 274 lymph nodes, harvested from 63 patients, were examined using ex vivo SWE. The data obtained from 228 of these nodes from 55 patients were included in the analysis. Results showed that 187 lymph nodes (82.0%) were nonmetastatic and 41 lymph nodes (18.0%) were metastatic. There was significant difference be-tween metastatic and nonmetastatic nodes with respect to the mean (45.4 kPa and 17.7 kPa, p< 0.001) and maximum (55.3 kPa and 23.2 kPa, p< 0.001) stiffness. The elasticity ratio was higher in the metastatic nodes (4.36 and 1.57, p< 0.001). Metastatic nodes were significantly larger than nonmetastatic nodes (mean size, 10.5 mm and 7.5 mm, p< 0.001). The size of metastatic nodes and nodal stiffness were correlated (correlation coefficient of mean stiffness, r= 0.553). The area under curve of mean stiffness, maximum stiffness, and elasticity ratio were 0.794, 0.802, and 0.831, respectively. Conclusion: Ex vivo SWE may be a feasible method to predict axillary lymph node metastasis intraoperatively in patients undergoing breast cancer surgery.

Original languageEnglish
Pages (from-to)190-196
Number of pages7
JournalJournal of Breast Cancer
Volume21
Issue number2
DOIs
Publication statusPublished - 2018 Jun

Fingerprint

Elasticity Imaging Techniques
Lymph Nodes
Breast Neoplasms
Neoplasm Metastasis
Elasticity
Polysorbates
Area Under Curve

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Bae, Soong June ; Park, Jong Tae ; Park, Ah Young ; Youk, Ji Hyun ; Lim, Jong Won ; Lee, Hak Woo ; Lee, Hak Min ; Ahn, Sung Gwe ; Son, Eun Ju ; Jeong, Joon. / Ex vivo shear-wave elastography of axillary lymph nodes to predict nodal metastasis in patients with primary breast cancer. In: Journal of Breast Cancer. 2018 ; Vol. 21, No. 2. pp. 190-196.
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title = "Ex vivo shear-wave elastography of axillary lymph nodes to predict nodal metastasis in patients with primary breast cancer",
abstract = "Purpose: There is still a clinical need to easily evaluate the metastatic status of lymph nodes during breast cancer surgery. We hypothesized that ex vivo shear-wave elastography (SWE) would predict precisely the presence of metastasis in the excised lymph nodes. Methods: A total of 63 patients who underwent breast cancer surgery were prospectively enrolled in this study from May 2014 to April 2015. The excised axillary lymph nodes were examined using ex vivo SWE. Metastatic status was confirmed based on the final histopathological diagnosis of the permanent section. Lymph node characteristics and elasticity values measured by ex vivo SWE were assessed for possible association with nodal metastasis. Results: A total of 274 lymph nodes, harvested from 63 patients, were examined using ex vivo SWE. The data obtained from 228 of these nodes from 55 patients were included in the analysis. Results showed that 187 lymph nodes (82.0{\%}) were nonmetastatic and 41 lymph nodes (18.0{\%}) were metastatic. There was significant difference be-tween metastatic and nonmetastatic nodes with respect to the mean (45.4 kPa and 17.7 kPa, p< 0.001) and maximum (55.3 kPa and 23.2 kPa, p< 0.001) stiffness. The elasticity ratio was higher in the metastatic nodes (4.36 and 1.57, p< 0.001). Metastatic nodes were significantly larger than nonmetastatic nodes (mean size, 10.5 mm and 7.5 mm, p< 0.001). The size of metastatic nodes and nodal stiffness were correlated (correlation coefficient of mean stiffness, r= 0.553). The area under curve of mean stiffness, maximum stiffness, and elasticity ratio were 0.794, 0.802, and 0.831, respectively. Conclusion: Ex vivo SWE may be a feasible method to predict axillary lymph node metastasis intraoperatively in patients undergoing breast cancer surgery.",
author = "Bae, {Soong June} and Park, {Jong Tae} and Park, {Ah Young} and Youk, {Ji Hyun} and Lim, {Jong Won} and Lee, {Hak Woo} and Lee, {Hak Min} and Ahn, {Sung Gwe} and Son, {Eun Ju} and Joon Jeong",
year = "2018",
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doi = "10.4048/jbc.2018.21.2.190",
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pages = "190--196",
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Ex vivo shear-wave elastography of axillary lymph nodes to predict nodal metastasis in patients with primary breast cancer. / Bae, Soong June; Park, Jong Tae; Park, Ah Young; Youk, Ji Hyun; Lim, Jong Won; Lee, Hak Woo; Lee, Hak Min; Ahn, Sung Gwe; Son, Eun Ju; Jeong, Joon.

In: Journal of Breast Cancer, Vol. 21, No. 2, 06.2018, p. 190-196.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ex vivo shear-wave elastography of axillary lymph nodes to predict nodal metastasis in patients with primary breast cancer

AU - Bae, Soong June

AU - Park, Jong Tae

AU - Park, Ah Young

AU - Youk, Ji Hyun

AU - Lim, Jong Won

AU - Lee, Hak Woo

AU - Lee, Hak Min

AU - Ahn, Sung Gwe

AU - Son, Eun Ju

AU - Jeong, Joon

PY - 2018/6

Y1 - 2018/6

N2 - Purpose: There is still a clinical need to easily evaluate the metastatic status of lymph nodes during breast cancer surgery. We hypothesized that ex vivo shear-wave elastography (SWE) would predict precisely the presence of metastasis in the excised lymph nodes. Methods: A total of 63 patients who underwent breast cancer surgery were prospectively enrolled in this study from May 2014 to April 2015. The excised axillary lymph nodes were examined using ex vivo SWE. Metastatic status was confirmed based on the final histopathological diagnosis of the permanent section. Lymph node characteristics and elasticity values measured by ex vivo SWE were assessed for possible association with nodal metastasis. Results: A total of 274 lymph nodes, harvested from 63 patients, were examined using ex vivo SWE. The data obtained from 228 of these nodes from 55 patients were included in the analysis. Results showed that 187 lymph nodes (82.0%) were nonmetastatic and 41 lymph nodes (18.0%) were metastatic. There was significant difference be-tween metastatic and nonmetastatic nodes with respect to the mean (45.4 kPa and 17.7 kPa, p< 0.001) and maximum (55.3 kPa and 23.2 kPa, p< 0.001) stiffness. The elasticity ratio was higher in the metastatic nodes (4.36 and 1.57, p< 0.001). Metastatic nodes were significantly larger than nonmetastatic nodes (mean size, 10.5 mm and 7.5 mm, p< 0.001). The size of metastatic nodes and nodal stiffness were correlated (correlation coefficient of mean stiffness, r= 0.553). The area under curve of mean stiffness, maximum stiffness, and elasticity ratio were 0.794, 0.802, and 0.831, respectively. Conclusion: Ex vivo SWE may be a feasible method to predict axillary lymph node metastasis intraoperatively in patients undergoing breast cancer surgery.

AB - Purpose: There is still a clinical need to easily evaluate the metastatic status of lymph nodes during breast cancer surgery. We hypothesized that ex vivo shear-wave elastography (SWE) would predict precisely the presence of metastasis in the excised lymph nodes. Methods: A total of 63 patients who underwent breast cancer surgery were prospectively enrolled in this study from May 2014 to April 2015. The excised axillary lymph nodes were examined using ex vivo SWE. Metastatic status was confirmed based on the final histopathological diagnosis of the permanent section. Lymph node characteristics and elasticity values measured by ex vivo SWE were assessed for possible association with nodal metastasis. Results: A total of 274 lymph nodes, harvested from 63 patients, were examined using ex vivo SWE. The data obtained from 228 of these nodes from 55 patients were included in the analysis. Results showed that 187 lymph nodes (82.0%) were nonmetastatic and 41 lymph nodes (18.0%) were metastatic. There was significant difference be-tween metastatic and nonmetastatic nodes with respect to the mean (45.4 kPa and 17.7 kPa, p< 0.001) and maximum (55.3 kPa and 23.2 kPa, p< 0.001) stiffness. The elasticity ratio was higher in the metastatic nodes (4.36 and 1.57, p< 0.001). Metastatic nodes were significantly larger than nonmetastatic nodes (mean size, 10.5 mm and 7.5 mm, p< 0.001). The size of metastatic nodes and nodal stiffness were correlated (correlation coefficient of mean stiffness, r= 0.553). The area under curve of mean stiffness, maximum stiffness, and elasticity ratio were 0.794, 0.802, and 0.831, respectively. Conclusion: Ex vivo SWE may be a feasible method to predict axillary lymph node metastasis intraoperatively in patients undergoing breast cancer surgery.

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