Multiparametric Ultrasound Evaluation of Axillary Lymph Nodes in Breast Cancer Patients

This study aims to evaluate benign and malignant axillary lymph nodes (LN) in breast cancer using multiparametric ultrasound (US). The morphological characteristics, stiffness, and VI differences between 52 benign and malignant LNs were statistically evaluated using B-mode US, shear wave elastography (SWE), and superb microvascular imaging (SMI) before biopsy. Significant cutoff values were determined using receiver operating characteristic (ROC) curve analysis. Malignant lymph nodes had higher short-axis diameters (SD), lower long-axis diameter/short axis diameter ratios (LD/SD), and increased cortical thickness (p=0.026, p=0.044, p=0.004, p=0.000, respectively). A cortical thickness above 3.1 mm (AUC: 0.751, sensitivity: 94.1%, specificity: 51.4%, p=0.0003), SD greater than 8.4 mm (AUC: 0.692, sensitivity: 41.1%, specificity: 91.4%, p= 0.0141), LD/SD ≤2 (AUC: 0.664, sensitivity: 76.5%, specificity: 48.6%, p=0.0355) and, a mean elasticity value above 26.2 kPa (AUC: 0.861, sensitivity: 70.6%, specificity: 91.4%, p