Classification of Ultrasound Features of Superficially Located Lymph Nodes

Abstract

Assessment of lymphatic drainage areas is a critical task in ultrasound (US) examination of organs and tissues involved in various pathological processes. Superficially located lymph nodes (LNs) are more accessible for US evaluation. The numerous LN changes identified in ultrasound often are challenging for interpretation. The proposed classification provides grading of the detected ultrasound features in superficial LNs into groups, facilitating a risk stratification system for LN malignancy. Objective. To stratify LN ultrasound features according to the degree of deviation from the normal pattern – from loss of benign features to appearance of signs of malignancy – and to establish a classification of changes in superficially located LN based on US findings. Results. The classification comprises six levels: normal/unchanged LNs; probably benign LN changes; indeterminate/uncertain LN changes; suspicious LN changes; highly suspicious LN changes; morphologically confirmed malignant LN. Conclusion. The presented Russian classification for risk stratification of malignancy in superficial LNs will enable a more accurate US assessment of superficial lymph nodes, allowing identification of distinct types of ultrasound structure and selection of suspicious lymph nodes for biopsy.