UTILITY OF ULTRASOUND CRITERIA OF ROUNDNESS INDEX TO DIFFERENTIATE BETWEEN BENIGN AND MALIGNANT CERVICAL LYMPHADENOPATHY

Objective: The purpose of this study was to assess the utility of ultrasound criteria of Roundness Index (RI) to differentiate between benign and malignant cervical lymphadenopathy. Methods: We evaluated 305 patients having clinically palpable enlarged cervical lymph nodes by using the grayscale ultrasound criteria of Roundness Index i.e. the ratio of longest diameter of the node to the shortest perpendicular diameter (RI). Nodes having RI 2 were considered as benign. This ultrasound diagnosis was verified with findings of fine needle aspiration cytology (FNAC) which was considered as gold standard for this study. Results: In total, out of the 305 patients the RI was less than two in 60 patients (19.67%) and was more than two in 245 patients (80.33%). Out of the total 244 patients with benign (80.00%) nodes, 237 (97.13%) had the index more than two. Out of the total 61(20%) patients with malignant nodes, 53 patients (86.88%) had the index less than two. Conclusions: The grey scale criterion of RI was 86.89% sensitive and 97.13% specific in differentiating between benign and malignant causes of lymph node enlargement. Our results indicate that RI can be utilized for early diagnosis and follow up of cases presenting with suspected neck nodes.