Evidence map›Paper›PMID 35290097›Full record

Observational studyThe British journal of radiology2022

Role of shear wave elastography as an adjunct to axillary ultrasonography in predicting nodal metastasis in breast cancer patients with suspicious nodes.

Vishnu Prasad Pulappadi, Shashi Paul, Smriti Hari, Ekta Dhamija, Smita Manchanda, Kamal Kataria, Sandeep Mathur, Kalaivani Mani, Ajay Gogia, Svs Deo

Abstract readObservational Study
In one paragraph

Observational study in The British journal of radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Vishnu Prasad PulappadiDepartment of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
Shashi PaulDepartment of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.ORCID 0000-0001-5864-3154
Smriti HariDepartment of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
Ekta DhamijaDepartment of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
Smita ManchandaDepartment of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
Kamal KatariaDepartment of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
Sandeep MathurDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Kalaivani ManiDepartment of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Ajay GogiaDepartment of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
Svs DeoDepartment of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India.
All India Institute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the role of shear wave elastography (SWE) of suspicious axillary lymph nodes and its combination with B-mode USG in predicting nodal metastasis in breast cancer patients.

methodsProspective observational study was performed from June 2018 to August 2020 on breast cancer patients with suspicious axillary nodes on USG. B-mode features (cortical thickness, effacement of fatty hilum, non-hilar blood flow and round shape) and SWE parameters (Emax, Emin, Emean and ESD) of the node with the thickest cortex were evaluated. Diagnostic performances of USG, SWE and their combination were estimated using pathological status of the node on biopsy as the gold standard.

resultsOf the 54 patients evaluated, optimal elasticity maps were obtained in 49 nodes of 49 patients (mean age, 46.3 ± 12.1 years; 48/49 (98%) females). On biopsy, 38 nodes (77.6%) had metastasis, while 11 (22.4%) had reactive hyperplasia. Emax, Emin, Emean and ESD of both cortex and hilum were significantly higher in metastatic than reactive nodes. Emax (cortex) ≥14.9 kPa had the best diagnostic performance (sensitivity, 73.7%; specificity, 81.8%). Cortical thickness ≥6.7 mm had the best diagnostic performance among B-mode features (sensitivity, 89.5%; specificity, 72.7%). Combining cortical thickness with effacement of fatty hilum and/or non-hilar blood flow yielded sensitivity of 89.5% and specificity of 90.9%. Addition of Emax (cortex) to cortical thickness and combination of ≥2 B-mode features increased their specificities to 90.9 and 100%, respectively.

conclusionsMetastatic axillary nodes are stiffer than reactive nodes on SWE in breast cancer patients. Emax (cortex) has the best diagnostic performance in differentiating between reactive hyperplasia and nodal metastasis. Combination of Emax (cortex) and cortical thickness increases the specificity for diagnosing metastasis, especially in nodes showing only cortical thickening. ADVANCES IN KNOWLEDGE: Combination of SWE and B-mode USG is highly specific for differentiating metastasis from reactive hyperplasia in suspicious nodes of breast carcinoma patients, especially in nodes with only cortical thickening.

Indexed as

Breast NeoplasmsElasticity Imaging TechniquesAdultAxillaFemaleHumansHyperplasiaLymph NodesMiddle AgedSensitivity and SpecificityUltrasonographyUltrasonography, Mammary

Identifiers

PMID35290097
PMCPMC12187213
OpenAlexW4221097552

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.