Prospective Evaluation of CEUS-URM in Axillary Lymph Nodes with Diffuse Cortical Thickening in Breast Cancer…

Cohort studyMedical sciences (Basel, Switzerland)· Jul 2026

Prospective Evaluation of CEUS-URM in Axillary Lymph Nodes with Diffuse Cortical Thickening in Breast Cancer Patients.

Roxana Pintican, Calin Schiau, Nicoleta Antone … Patriciu Achimas-Cadariu

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PathologyCohort studyDiagnosisQ1IF 6.0

Contrast-enhanced ultrasound score discriminated metastatic axillary nodes with diffusely thickened cortex

Prospective Evaluation of CEUS-URM in Axillary Lymph Nodes with Diffuse Cortical Thickening in Breast Cancer Patients.

Roxana Pintican … Patriciu Achimas-Cadariu

Medical sciences (Basel, Switzerland) · Jul 2026 · Q1 in General Medicine

Background

Conventional axillary ultrasound (ultrasound) is least reliable in lymph nodes with diffusely thickened cortex.

Methods

This was a prospective single-center study of patients with histologically confirmed breast cancer; one index (most suspicious) node per patient (unit of analysis = index node).

n = 181

Results

Good ability to separate cancer-containing from cancer-free underarm lymph nodes

AUC 0.81 (95% CI 0.68 to 0.92)

CI excludes the null - significant

More results

Within the diagnostically challenging subgroup of lymph nodes with diffusely thickened cortex, conventional axillary ultrasound alone demonstrated limited discriminatory performance for metastatic involvement (AUC 0.43).

CEUS-derived quantitative parameters significantly improved diagnostic accuracy, with the best individual parameter achieving an AUC of 0.68.

More results

At a low threshold, the CEUS score showed high sensitivity (93%), suitable for screening and exclusion of nodal metastases, while at a higher threshold it achieved high specificity (96%), allowing reliable confirmation of metastatic disease.

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Conclusion · 1 of 2

In this exploratory study, a simple CEUS-URM score improved discrimination of diffusely thickened axillary nodes and may serve as an adjunct to conventional ultrasound.

Conclusion · 2 of 2

The findings are preliminary-derived and tested in the same small cohort-and require external, within-patient paired validation.

Prospective Evaluation of CEUS-URM in Axillary Lymph Nodes with Diffuse Cortical Thickening in Breast Cancer Patients.

Prospective Evaluation of CEUS-URM in Axillary Lymph Nodes with Diffuse Cortical Thickening in Breast Cancer Patients.

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