Differentiating benign from malignant mediastinal lymph nodes visible at <scp>EBUS</scp> using grey‐scale textural analysis

Edey, Anthony; Pollentine, Adrian; Afanasiev, Michael; Medford, Andrew R L

doi:10.1111/resp.12467

Cited by 13 publications

(12 citation statements)

References 15 publications

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“…We read with interest the manuscript published by Edey et al 'Differentiating benign from malignant mediastinal lymph nodes visible at EBUS using greyscale textural analysis'. 1 Their results did not replicate ours, apart from showing a higher entropy in malignant nodes compared with benign nodes. 2 However, there are differences in methodology between the studies that may explain their negative results.…”

Section: Optical Differentiation Between Malignant and Benign Lymphadmentioning

confidence: 59%

Optical differentiation between malignant and benign lymphadenopathy by EBUS using grey scale texture analysis

Nguyen

Fielding

2015

Respirology

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Hillebrand et al. published in 2015 2 contains some very important observation/conclusion that we will consider for future perspectives of studies in patients with COPD.As discussed in our study, one of the limitations was the use of medication prior to the assessments of autonomic function and physical fitness which may have influenced the results of these tests; however, our assessments were performed considering the 'real-life' condition of these patients with COPD. However, there are differences in methodology between the studies that may explain their negative results. MarceliEdey's group only studied one first-order and one second-order greyscale parameter. Our study looked at many parameters and found five significant factors to analyse lymph nodes in the validation set by calculating a combined likelihood ratio. Each factor was statistically discriminatory for malignant from benign nodes, allowing multiplication of results, strengthening our likelihood ratios. This is particularly relevant because the bronchoscope model in Edey's paper (BF-UC260FW) uses an updated ultrasound processor to ours with more image adjustment modes possible. The authors state that image acquisition was standardized to default settings; however, differences in image acquisition by this processor mean a broader initial assessment across the full range of greyscale parameters would have been potentially more revealing. We stated a GI3 setting and a thermal index for soft tissue as our settings as well as machine defaults. We acknowledged that results applied only to the equipment we used and that multicentre studies using that equipment would be needed.In the recent study digital images were saved to removable media and a single still image was captured avoiding artefact. In our study digital video recording of the whole procedure was reviewed frame by frame to allow selection of the image which was completely free of even the slightest motion or balloon artefact and which gave the node at its largest allowing for the small rotations of image which inevitably occur. This allows such things as large bronchial vessels to be easily excluded from the image. Despite the expertise in the procedure by Edey's group, using only a single image retrospectively may have impacted image quality in a percentage of images and hence greyscale results.Edey's group reports mean size for all lymph nodes based on diameter and states regions of interest (ROI) were 'greater than 32 pixels'. We assume this meant that ROIs were 'greater than 32 × 32 pixels', as in our dataset, the smallest lymph node analysed was 1000 pixels in size and the largest malignant node was >91 000 pixels in size. The exact size is important as it can impact on the amount of greyscale data available to be analysed within each lymph node. Indeed our benign nodes were significantly smaller (as is often the case clinically) which may have contributed to their measured homogeneity by a range of pathological mechanisms. We agree that larger data sets could help to clarify this rel...

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Section: Optical Differentiation Between Malignant and Benign Lymphadmentioning

confidence: 59%

Optical differentiation between malignant and benign lymphadenopathy by EBUS using grey scale texture analysis

Nguyen

Fielding

2015

Respirology

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“…44 To access those lymph nodes, EBUS can be done in conjunction with transesophageal endoscopy (EUS). 45 Though there is data to support the use of ultrasound echo-texture characteristics to differentiate between malignant and benign lymph nodes, 46,47…”

Section: Ebus Cannot Access Paraesophageal Lymph Nodes and While Ebumentioning

confidence: 99%

“…To access those lymph nodes, EBUS can be done in conjunction with transesophageal endoscopy (EUS) . Though there is data to support the use of ultrasound echo‐texture characteristics to differentiate between malignant and benign lymph nodes, lymph nodes that are 0.5 cm or greater in short‐axis diameter on EBUS analysis should be considered for transbronchial needle aspiration (TBNA). Thorough evaluation of bilateral hila and mediastinum should be performed during the EBUS evaluation in light of the false‐negative rate of nuclear and radiologic staging .…”

Section: Introductionmentioning

confidence: 99%

Committee II: Guidelines for cytologic sampling techniques of lung and mediastinal lymph nodes

Michael

Faquin

Jing

et al. 2018

Diagnostic Cytopathology

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The Papanicolaou Society of Cytopathology has developed a set of guidelines for pulmonary cytology including indications for bronchial brushings, washings, and endobronchial ultrasound guided transbronchial fine-needle aspiration (EBUS-TBNA), technical recommendations for cytological sampling, recommended terminology and classification schemes, recommendations for ancillary testing and recommendations for post-cytological management and follow-up. All recommendations are based on the expertise of the authors, an extensive literature review and feedback from presentations at national and international conferences. This document selectively presents the results of these discussions. The present document summarizes recommendations regarding techniques used to obtain cytological and small histologic specimens from the lung and mediastinal lymph nodes including rapid on-site evaluation (ROSE), and the triage of specimens for immunocytochemical and molecular studies.

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“…Consecutive 135 EBUS lymph node images were evaluated for greyscale texture (pixels and entropy) using MATLAB software (MathWorks, Inc., Natick, MA, USA) . Receiver‐operating characteristic curves were generated for 94 patients and thresholds applied to subsequent 41 subjects.…”

Section: Bronchoscopic Intervention and Imagingmentioning

confidence: 99%

Year in review 2015: Lung cancer, pleural diseases, respiratory infections, bronchiectasis and tuberculosis, bronchoscopic intervention and imaging

et al. 2016

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Differentiating benign from malignant mediastinal lymph nodes visible at EBUS using grey‐scale textural analysis

Abstract: These findings suggest that use of EBUS grey-scale textural analysis for differentiation of malignant from benign lymphadenopathy may not be accurate. Further studies are required.

Cited by 13 publications

References 15 publications

Optical differentiation between malignant and benign lymphadenopathy by EBUS using grey scale texture analysis

Optical differentiation between malignant and benign lymphadenopathy by EBUS using grey scale texture analysis

Committee II: Guidelines for cytologic sampling techniques of lung and mediastinal lymph nodes

Year in review 2015: Lung cancer, pleural diseases, respiratory infections, bronchiectasis and tuberculosis, bronchoscopic intervention and imaging

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