Metastatic peripheral lymph nodes in cutaneous malignant melanoma: role of shear wave elastography

From January to August 2017, lymph nodes ultrasound examination was performed to 51 patients (23 men and 28 women) (23-86 years old) with a histologically verified cutaneous malignant melanoma diagnosis. In all patients metastasis in lymph nodes of different localization (axillary, cervical, and inguinal lymph nodes) were suspected according to gray-scale and Doppler ultrasound. All patients were examined using ultrasound system Aplio 500 (Toshiba, Japan) with linear transducer 7-18 MHz. The first group included 21 patients with confirmed metastatic lymph nodes, the second - 30 patients with hyperplasia of lymphoid reticular tissue. Young’s modulus values for metastatic lymph nodes were 101.8 kPa (median), 14.0-164.5 kPa (2.5-97.5^th percentiles), for hyperplastic lymph nodes - 15.0 kPa, 7.2-56.8 kPa, respectively. Significant differences in Young’s modulus values between metastatic and hyperplastic lymph nodes in patients with cutaneous malignant melanoma were revealed (P < 0.0001). Young’s modulus values in metastatic lymph nodes were not correlated with Clark level of melanoma invasion, nor with the localization of metastases (axillary, cervical, and inguinal lymph nodes). The best Young’s module cut-off value for metastatic lymph nodes detection in case of skin melanoma was 22.7 kPa (sensitivity - 86%, specificity - 77%, AUC - 0,916).

ультразвуковая эластография, эластография сдвиговой волной, злокачественная меланома кожи, уровень инвазии по Кларку, толщина по Бреслоу, лимфатические узлы, модуль Юнга, скорость сдвиговой волны, ultrasound elastography, shear wave elastography, cutaneous malignant melanoma, Clark level of invasion, Breslow thickness, lymph nodes, Young’s modulus, shear wave velocity

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