Virtual touch tissue imaging quantification and conventional ultrasound in diagnosis of metastatic axillary lymph nodes in patients with breast cancer

Objective To evaluate the value of virtual touch tissue imaging quantification (VTIQ) and conventional ultrasound (US) in the diagnosis of axillary lymph nodes in breast cancer patients. Methods Totally, 107 axillary lymph nodes of 107 patients were measured by conventional US and VTIQ from June 2017 to March 2018 in QianFoshan Hospital of Shandong Province. The US score and the shear wave velocity (SWV) values were obtained. According to pathology results, receiver operating characteristic curve analysis was performed to find the optimal cut-off point in differentiating malignant from benign lesions. The diagnostic value of US, VTIQ, and concurrent and sequential combination of the two were compared. Results SWVmax, SWVmin, and SWVmean values of malignant lymph nodes were significantly higher than those of benign lymph nodes (P<0.01). When the US score ≥ 6 or the SWVmean ≥ 1.88 m/s, the lymph nodes were more likely to be malignant. The specificity and accuracy of VTIQ were higher than those of US, but there were no statistically significant differences between them. The sensitivity of the concurrent combination was significantly higher than that of conventional US (94.4% vs 70.4%, P<0.05), and the specificity of the sequential combination was significantly higher than that of conventional US (96.2% vs 79.2%, P<0.05). Conclusion Conventional US and VTIQ can help to diagnose axillary lymph nodes. The combination of conventional US and VTIQ can effectively improve the ability of ultrasound in the diagnosis of benign and malignant axillary lymph nodes. Key words: Breast cancer; Axillary lymph nodes; Ultrasound; Virtual touch tissue imaging quantification