The value of strain ratio measurement in differentiation between benign and malignant lymphadenopathy

Differentiating benign and malignant process on lymphadenopathy is very important because it determines the disease and the treatment. Currently, we use invasive method, such as biopsy, to obtain cell or tissue sample to make a decision whether the lymph node is benign or malignant. Ultrasonography (US) is a simple, inexpensive, and easy-to-obtained alternative imaging method compared to PET Scan that can be used to examine metastatic process on lymph nodes. To visualize relative strain distribution in soft tissue, it needs an ultrasound-based method called real time elastography. By measure the strain of two different user-divined areas in an elastogram, a semiquantitative measurement can be perfomed, and it called strain ratio. This study was conducted at Dr. Soetomo Hospital include 40 consecutive sampling that the affordable total population fit with inclusion criteria. The aim of this study was to investigate the correlations between strain ratio measurements with pathology result of cervical lymphadenopathy caused by different pathology. Elastography profile was obtained by US elastography test while to differentiate benign or malignant process, fine needle aspiration biopsy (FNAB) pathology was done. Result: The mean of strain ratio was 3.088 with standard deviation 3.978. The minimum value of strain ratio is 0.21 while the maximum value is 20.11. The correlation test showed p=0.049 which means a significant correlation between strain ratio and the malignant process of the lymph nodes. The strain ratio measurement is a non invasive and an alternative valuable method to make a differentiation between benign and malignant process on cervical lymphadenopathy.