# Ultrasonography and sonoelastography in cervical lymph node differentiation: A cross-sectional study

## TL;DR

This study shows that combining ultrasound with a new stiffness-measuring technique improves accuracy in telling if neck lymph nodes are benign or cancerous.

## Contribution

The novel contribution is demonstrating that integrating shear wave elastography with conventional ultrasound significantly improves cervical lymph node differentiation.

## Key findings

- Shear wave elastography, particularly perinodal rim stiffness, showed the highest individual diagnostic accuracy.
- Combining B-mode, Doppler, and shear wave elastography achieved 94% overall accuracy in differentiating benign and malignant lymph nodes.

## Abstract

Cervical lymphadenopathy poses a diagnostic challenge, particularly in distinguishing benign from malignant lymph nodes non-invasively.
Therefore, it is of interest to evaluate the diagnostic utility of B-mode ultrasonography, color Doppler, strain elastography and shear
wave elastography in 100 patients at a tertiary center in East India. Histopathology served as the reference standard to determine sensitivity,
specificity and AUC for each modality. Shear wave elastography, especially perinodal rim stiffness, showed the highest individual accuracy,
while the combined B-mode-Doppler-SWE approach demonstrated 94% overall accuracy. Thus, we show that integrating shear wave elastography
with conventional ultrasonography significantly enhances differentiation of benign and malignant cervical lymph nodes.