This study was undertaken to evaluate the diagnostic efficacy of sonoelastography in the differentiation of benign and metastatic cervical lymph nodes by correlating with histologic nodal findings. This was a prospective single centre study wherein sonoelastography was performed for a period of fourteen months on fourty patients with palpable cervical lymph nodes suspected to have metastasis. These cervical lymph nodes were evaluated based on gray scale ultrasound (short axis diameter, short:long axis ratio, shape, echogenicity, border, presence or absence of central fatty hilum and calcification), colour doppler ultrasound (vascularity) and ultrasound elastography (elastography score and strain index) features and further compared with fine needle aspiration cytology and surgical histopathological findings. Of the 40 patients included in this study and comparing the gray scale ultrasound, colour doppler ultrasound, ultrasound elastography features and fine needle aspiration cytology findings of cervical lymph nodes with gold standard reference histopathology finding, strain index, an ultrasound elastography feature was found to show good agreement ( K-value : 0.80 ) and the most promising variable to differentiate malignant and benign cervical lymph nodes with 97.06% sensitivity, 83.33% specificity, PPV of 97.06%, NPV of 83.33% and 95% accuracy, whereas ultrasound elastography scoring scale showed moderate agreement (K-value : 0. 61) with 97.06% sensitivity, 50% specificity, PPV of 91.67%, NPV of 75% and 90% accuracy. In this study it was found that sonoelastography was a promising non invasive and rapidly developing imaging technique with easy availability, less expensive, short examination time, realtime display and immediate interpretation that can provide assistance in the differentiation of benign and metastatic cervical lymph nodes thus precluding unnecessary fine needle aspiration cytology in a significant number of patients.
