The role of ultrasound elastography and virtual touch tissue imaging in the personalized prediction of lymph node metastasis of breast cancer

Jue Wang; Zhifei Ben; Shanshan Gao; Shuyi Lyu; Xiuzhi Wei

doi:10.21037/gs-21-199

The role of ultrasound elastography and virtual touch tissue imaging in the personalized prediction of lymph node metastasis of breast cancer

Gland Surg. 2021 Apr;10(4):1460-1469. doi: 10.21037/gs-21-199.

Authors

Jue Wang¹, Zhifei Ben¹, Shanshan Gao¹, Shuyi Lyu², Xiuzhi Wei¹

Affiliations

¹ Department of Ultrasound, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China.
² Department of Interventional Therapy, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China.

Abstract

Background: This study examined the effects of different ultrasound imaging technologies in the identification and prediction of axillary lymph node metastasis of breast cancer. It also investigated the relationship between human papilloma virus (HPV) infection and axillary lymph node metastasis.

Methods: Eighty-five female patients diagnosed with breast masses participated in this study. Each patient underwent a conventional ultrasound, ultrasonic elastography, and virtual touch tissue imaging quantification (VTIQ). The differential diagnosis efficiency of a conventional ultrasound, ultrasound elastography, VTIQ, and ultrasound elastography combined with VTIQ technology was compared with a pathological diagnosis, which represents the gold standard. 85 axillary lymph node tissues and 25 normal breast tissues were used to detect HPV positive infection rate differences in different tissues.

Results: The results showed that metastatic lymph nodes and reactive lymph node hyperplasia accounted for 54.12% and 45.88% of the 85 axillary lymph nodes of breast cancer, respectively. The conventional ultrasound, ultrasound elastography, and VTIQ scores of metastatic lymph nodes were significantly higher than those of reactive lymph node hyperplasia (P<0.05). The diagnostic sensitivity (Se) (91.30%), specificity (Sp) (92.31%), accuracy (Ac) (91.76%), positive predictive value (PPV) (93.33%), and negative predictive value (NPV) (90.00%) of ultrasound elastography combined with VTIQ technology were the highest among the diagnostic efficiency test results of different computer ultrasound imaging technologies. The positive infection rate of HPV in metastatic lymph node tissues was significantly higher than that in reactive lymph node hyperplasia and normal breast tissues (P<0.05).

Conclusions: Combining ultrasound elastography with VTIQ technology has high value in the differential diagnosis of axillary lymph nodes of breast cancer. Further, it appears that HPV infection may have an etiological role in lymph node metastasis in breast cancer patients.

Keywords: Axillary lymph node metastasis in breast cancer; computer ultrasonic imaging technology; human papilloma virus infection (HPV infection); metastatic lymph nodes; reactive lymph node hyperplasia.