Efficacy of Shear-Wave Elastography for Detecting Postoperative Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma

<div>Scatter dot plots of shear-wave elastography measurements for benign (<svg height="8.55521pt" id="M63" style="vertical-align:-0.2063904pt" version="1.1" viewbox="-0.0498162 -8.34882 34.1002 8.55521" width="34.1002pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M495 86L479 114C446 82 419 66 409 66C401 66 401 72 406 97C420 166 436 231 453 297C489 435 454 448 428 448C406 448 384 439 354 422C305 394 222 327 161 247H159L183 345C200 415 194 448 173 448C143 448 82 410 23 351L38 325C64 349 95 371 105 371C111 371 116 365 109 336L25 -4L31 -12C50 -4 77 3 107 9C119 69 132 122 145 168C197 254 321 381 370 381C387 381 393 374 378 305L329 95C309 17 320 -12 345 -12C372 -12 430 19 495 86Z" id="g113-111"></path></g><g transform="matrix(.013,0,0,-0.013,10.158,0)"><path d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z" id="g117-34"></path></g><g transform="matrix(.013,0,0,-0.013,21.421,0)"><path d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z" id="g113-52"></path></g><g transform="matrix(.013,0,0,-0.013,27.661,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" id="g113-50"></path></g></svg>) and malignant (<svg height="8.55521pt" id="M64" style="vertical-align:-0.2063904pt" version="1.1" viewbox="-0.0498162 -8.34882 34.1002 8.55521" width="34.1002pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M495 86L479 114C446 82 419 66 409 66C401 66 401 72 406 97C420 166 436 231 453 297C489 435 454 448 428 448C406 448 384 439 354 422C305 394 222 327 161 247H159L183 345C200 415 194 448 173 448C143 448 82 410 23 351L38 325C64 349 95 371 105 371C111 371 116 365 109 336L25 -4L31 -12C50 -4 77 3 107 9C119 69 132 122 145 168C197 254 321 381 370 381C387 381 393 374 378 305L329 95C309 17 320 -12 345 -12C372 -12 430 19 495 86Z" id="g113-111"></path></g><g transform="matrix(.013,0,0,-0.013,10.158,0)"><path d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z" id="g117-34"></path></g><g transform="matrix(.013,0,0,-0.013,21.421,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" id="g113-50"></path></g><g transform="matrix(.013,0,0,-0.013,27.661,0)"><path d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z" id="g113-51"></path></g></svg>) lymph nodes in papillary thyroid carcinoma. (a) Mean elasticity (<svg height="11.9316pt" id="M65" style="vertical-align:-3.2957pt" version="1.1" viewbox="-0.0498162 -8.6359 29.6885 11.9316" width="29.6885pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M593 650H142L136 622C219 616 224 611 209 531L130 120C114 39 108 34 23 28L17 0H501C518 32 557 130 568 158L540 169C519 132 495 93 469 70C439 43 409 35 332 35C272 35 241 37 225 50C211 61 211 89 222 149L253 320H350C441 320 443 312 441 239H471L510 434H481C455 366 448 358 360 358H260L303 572C311 613 312 615 348 615H431C509 615 522 603 532 581C544 555 546 531 545 491L574 493C583 555 592 631 593 650Z" id="g113-70"></path></g><g transform="matrix(.0091,0,0,-0.0091,7.943,3.132)"><path d="M871 0V33C783 41 780 45 777 152L768 506C765 610 771 609 860 617V650H683L453 157L228 650H59V617C150 609 154 606 146 481L132 275C124 170 117 125 112 93C105 50 84 39 27 34V0H267V34C200 39 176 48 173 93C170 130 171 172 176 256L190 540H192L414 8H438L682 554H685L689 152C689 45 686 41 604 33V0H871Z" id="g58-75"></path></g><g transform="matrix(.0091,0,0,-0.0091,15.923,3.132)"><path d="M384 109C349 76 310 59 268 59C197 59 123 113 120 245C240 248 367 259 384 262C403 266 407 275 407 296C407 376 338 451 254 451H253C201 451 148 425 105 378C65 334 39 272 39 203C39 88 112 -12 235 -12C266 -12 339 5 402 84L384 109ZM230 411C285 411 319 365 319 313C319 298 313 293 294 293C236 291 180 290 125 290C141 370 185 411 230 411Z" id="g58-99"></path></g><g transform="matrix(.0091,0,0,-0.0091,19.909,3.132)"><path d="M442 39L431 68C420 63 406 57 394 57C377 57 359 71 359 118V301C359 353 349 393 314 424C291 443 261 451 230 451C171 438 107 401 79 381C59 366 46 355 46 340C46 316 72 295 91 295C106 295 117 303 122 319C131 350 139 371 152 384C163 397 178 404 197 404C246 404 281 365 281 293V278C260 262 186 232 124 213C69 194 41 161 41 112C41 47 92 -12 163 -12C195 -12 243 25 283 51C288 35 293 22 308 7C319 -4 339 -12 354 -12L442 39ZM281 87C262 68 226 51 199 51C169 51 129 74 129 126C129 162 151 181 190 198C211 208 259 229 281 240V87Z" id="g58-95"></path></g><g transform="matrix(.0091,0,0,-0.0091,23.912,3.132)"><path d="M532 0V30C473 38 467 38 467 107V298C467 395 416 451 336 451C307 451 279 439 251 420C226 404 205 389 185 374V453C142 434 94 422 43 413V386C98 378 104 373 104 309V107C104 41 100 38 31 30V0H251V30C191 35 185 40 185 107V337C216 364 255 389 295 389C360 389 386 347 386 276V110C386 44 380 35 321 30V0H532Z" id="g58-108"></path></g></svg>). (b) Minimum elasticity (<svg height="11.8174pt" id="M66" style="vertical-align:-3.1815pt" version="1.1" viewbox="-0.0498162 -8.6359 24.3543 11.8174" width="24.3543pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M593 650H142L136 622C219 616 224 611 209 531L130 120C114 39 108 34 23 28L17 0H501C518 32 557 130 568 158L540 169C519 132 495 93 469 70C439 43 409 35 332 35C272 35 241 37 225 50C211 61 211 89 222 149L253 320H350C441 320 443 312 441 239H471L510 434H481C455 366 448 358 360 358H260L303 572C311 613 312 615 348 615H431C509 615 522 603 532 581C544 555 546 531 545 491L574 493C583 555 592 631 593 650Z" id="g113-70"></path></g><g transform="matrix(.0091,0,0,-0.0091,7.943,3.132)"><path d="M871 0V33C783 41 780 45 777 152L768 506C765 610 771 609 860 617V650H683L453 157L228 650H59V617C150 609 154 606 146 481L132 275C124 170 117 125 112 93C105 50 84 39 27 34V0H267V34C200 39 176 48 173 93C170 130 171 172 176 256L190 540H192L414 8H438L682 554H685L689 152C689 45 686 41 604 33V0H871Z" id="g58-75"></path></g><g transform="matrix(.0091,0,0,-0.0091,16.096,3.132)"><path d="M138 535C169 535 191 560 191 589C191 620 168 644 139 644S85 620 85 589C85 560 110 535 138 535ZM257 0V30C192 35 185 43 185 109V453C142 435 94 422 40 414V386C101 378 104 372 104 311V109C104 41 97 35 33 30V0H257Z" id="g58-103"></path></g><g transform="matrix(.0091,0,0,-0.0091,18.599,3.132)"><path d="M532 0V30C473 38 467 38 467 107V298C467 395 416 451 336 451C307 451 279 439 251 420C226 404 205 389 185 374V453C142 434 94 422 43 413V386C98 378 104 373 104 309V107C104 41 100 38 31 30V0H251V30C191 35 185 40 185 107V337C216 364 255 389 295 389C360 389 386 347 386 276V110C386 44 380 35 321 30V0H532Z" id="g58-108"></path></g></svg>). (c) Maximum elasticity (<svg height="11.9316pt" id="M67" style="vertical-align:-3.2957pt" version="1.1" viewbox="-0.0498162 -8.6359 25.1763 11.9316" width="25.1763pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M593 650H142L136 622C219 616 224 611 209 531L130 120C114 39 108 34 23 28L17 0H501C518 32 557 130 568 158L540 169C519 132 495 93 469 70C439 43 409 35 332 35C272 35 241 37 225 50C211 61 211 89 222 149L253 320H350C441 320 443 312 441 239H471L510 434H481C455 366 448 358 360 358H260L303 572C311 613 312 615 348 615H431C509 615 522 603 532 581C544 555 546 531 545 491L574 493C583 555 592 631 593 650Z" id="g113-70"></path></g><g transform="matrix(.0091,0,0,-0.0091,7.943,3.132)"><path d="M871 0V33C783 41 780 45 777 152L768 506C765 610 771 609 860 617V650H683L453 157L228 650H59V617C150 609 154 606 146 481L132 275C124 170 117 125 112 93C105 50 84 39 27 34V0H267V34C200 39 176 48 173 93C170 130 171 172 176 256L190 540H192L414 8H438L682 554H685L689 152C689 45 686 41 604 33V0H871Z" id="g58-75"></path></g><g transform="matrix(.0091,0,0,-0.0091,16.014,3.132)"><path d="M442 39L431 68C420 63 406 57 394 57C377 57 359 71 359 118V301C359 353 349 393 314 424C291 443 261 451 230 451C171 438 107 401 79 381C59 366 46 355 46 340C46 316 72 295 91 295C106 295 117 303 122 319C131 350 139 371 152 384C163 397 178 404 197 404C246 404 281 365 281 293V278C260 262 186 232 124 213C69 194 41 161 41 112C41 47 92 -12 163 -12C195 -12 243 25 283 51C288 35 293 22 308 7C319 -4 339 -12 354 -12L442 39ZM281 87C262 68 226 51 199 51C169 51 129 74 129 126C129 162 151 181 190 198C211 208 259 229 281 240V87Z" id="g58-95"></path></g><g transform="matrix(.0091,0,0,-0.0091,20.1,3.132)"><path d="M482 0V30C420 38 407 48 370 103L273 248C308 299 331 332 352 357C387 397 401 404 463 409V439H277V409C318 405 324 400 307 369C290 337 270 307 251 279L194 367C175 396 180 402 220 409V439H18V409C74 401 87 395 117 349L204 213C173 168 147 130 119 95C78 46 67 38 5 30V0H195V30C144 38 143 47 162 79C181 112 202 149 225 181L297 70C314 43 307 35 264 30V0H482Z" id="g58-118"></path></g></svg>). (d) One standard deviation of elastographic values (<svg height="11.9316pt" id="M68" style="vertical-align:-3.2957pt" version="1.1" viewbox="-0.0498162 -8.6359 19.6867 11.9316" width="19.6867pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M593 650H142L136 622C219 616 224 611 209 531L130 120C114 39 108 34 23 28L17 0H501C518 32 557 130 568 158L540 169C519 132 495 93 469 70C439 43 409 35 332 35C272 35 241 37 225 50C211 61 211 89 222 149L253 320H350C441 320 443 312 441 239H471L510 434H481C455 366 448 358 360 358H260L303 572C311 613 312 615 348 615H431C509 615 522 603 532 581C544 555 546 531 545 491L574 493C583 555 592 631 593 650Z" id="g113-70"></path></g><g transform="matrix(.0091,0,0,-0.0091,7.943,3.132)"><path d="M416 501L399 642C356 655 314 665 271 665C140 665 63 582 63 486C63 372 163 325 229 290C304 250 359 217 359 142C359 70 316 25 240 25C138 25 94 125 78 186L44 178C52 123 64 45 72 21C81 16 96 8 121 0S179 -15 220 -15C353 -15 445 68 445 176C445 289 350 335 270 375C191 414 143 449 143 520C143 572 177 627 253 627C340 627 366 556 382 495L416 501Z" id="g58-81"></path></g><g transform="matrix(.0091,0,0,-0.0091,12.247,3.132)"><path d="M43 650V617C122 612 130 606 130 522V128C130 44 122 37 34 32V0H275C400 0 497 25 573 82C652 142 698 229 698 350C698 445 662 518 613 565C549 625 456 650 327 650H43ZM217 544C217 580 220 591 229 599C240 607 264 613 311 613C380 613 437 599 482 570C561 523 598 436 598 336C598 177 511 40 324 40C248 40 217 61 217 135V544Z" id="g58-66"></path></g></svg>). kPa: kilopascal. Central bars denote median.</div>

International Journal of Endocrinology

fig2

Figure 2

Figure 2: Efficacy of Shear-Wave Elastography for Detecting Postoperative Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma 