Usefulness of shear-wave elastography for detection of lymph node metastasis in esophageal and gastric cancer

Figure 1 Study protocol chart for patient selection. GC: Gastric cancer; EC: Esophageal cancer.

Figure 2 Measurement by shear-wave elastography. A: Lymph nodes and fat tissue depicted by ultrasound in B mode; B: Measurement by shear-wave elastography. In this case, the shear wave velocity is 4.78 m/s. Therefore, this lymph node is determined “clinically positive”.

Figure 3 Study protocol chart for measuring lymph node hardness with shear wave elastography. EC: Esophageal cancer; GC: Gastric cancer; SWE: Shear wave elastography.

Figure 4 Receiver operating characteristic curves. A-C: Shear-wave elastography measurements. In the analysis of all lymph nodes, the receiver operating characteristic (ROC) curve shows an area under the curve (AUC) of 0.80 [95% confidence interval (CI): 0.75-0.85] (A); BIn the esophageal cancer (EC) analysis, the ROC curve shows an AUC of 0.79 (95%CI: 0.68-0.91) (B); In the gastric cancer (GC) analysis, the ROC curve shows an AUC of 0.81 (95%CI: 0.75-0.87) (C); D-F: Lymph node sizes and cutoff values. In the analysis of all lymph nodes, the cutoff value is calculated as 5.10 mm, with the ROC curve showing an AUC of 0.74 (95%CI: 0.69-0.80) (D); In the EC analysis, the cutoff value is 5.40 mm, with an AUC of 0.83 (95%CI: 0.74-0.91) (E); In the GC analysis, the cut off value is 5.10 mm, with an AUC of 0.74 (95%CI: 0.67-0.81) (F).