Sonographic Features of Endobronchial Ultrasonography Predict Intrathoracic Lymph Node Metastasis in Lung Cancer Patients

Wang, Lei; Wu, Weihua; Hu, Yunqian; Teng, Jinfang; Zhong, Runbo; Han, Baohui; Sun, Jiayuan

doi:10.1016/j.athoracsur.2015.04.143

Cited by 45 publications

(67 citation statements)

References 25 publications

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“…Although EBUS imaging of conventional B-mode and power Doppler are very useful for the detection of intrathoracic LNs, the differential diagnosis between benign and malignant lesions remains difficult and has its limitations [8][9][10] . In our study, the most commonly used criteria for differential diagnosis in the decreasing order of importance according to diagnostic accuracy are as follows: nonhilar perfusion of vascular pattern (70.31%), absence of CHS (66.67%), echogenicity (56.06%), round shape (54.55%), short axis >1 cm (53.03%), and distinct margin (50.00%).…”

Section: Discussionmentioning

confidence: 99%

“…Based on previous studies of EBUS B-mode and vascular patterns on Doppler [7][8][9][10] , malignant LNs characteristics were described according to the following characteristics: short axis with a diameter >1 cm; round shape; heterogeneous echogenicity; absence of central hilar structure (CHS); distinct margin and nonhilar perfusion of vascular pattern including central, capsular, and mixed (2 or more kinds mixed from hilar, central, and capsular vascular patterns). Digital videos and images of all LNs obtained by CP-EBUS were reviewed and analyzed independently by 2 operators and a sonographer, who were blinded to the results of EBUS-TBNA.…”

Section: Ebus Characteristics Of B-mode and Vascular Patternsmentioning

confidence: 99%

“…However, these features are limited either in sensitivity or specificity, and no single criterion for malignant LNs had a satisfactory predictive value. Although combining various factors of sonographic measurements could improve its accuracy, this largely increases the difficulties for bronchoscopists during clinical practice [10] .…”

Section: Introductionmentioning

confidence: 99%

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Endobronchial Ultrasound Elastography for Evaluation of Intrathoracic Lymph Nodes: A Pilot Study

Sun

Zheng²,

Mao³

et al. 2017

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Background: Endobronchial ultrasound (EBUS) elastography is a new imaging procedure for describing the elasticity of intrathoracic lesions and providing important additional diagnostic information. Objectives: The aim of this study was to utilize the feasibility of qualitative and quantitative methods to evaluate the ability of EBUS elastography to differentiate between benign and malignant mediastinal and hilar lymph nodes (LNs) during EBUS-guided transbronchial needle aspiration (EBUS-TBNA). Methods: Patients with enlarged intrathoracic LNs required for EBUS-TBNA examination at a clinical center for thoracic medicine from January 2014 to April 2014 were prospectively enrolled. EBUS sonographic characteristics on B-mode, vascular patterns and elastography, EBUS-TBNA procedures, pathological findings, and microbiological results were recorded. Furthermore, elastographic patterns (qualitative method) and the mean gray value inside the region of interest (quantitative method) were analyzed. Both methods were compared with a definitive diagnosis of the involved LNs. Results: Fifty-six patients including 68 LNs (33 benign and 35 malignant nodes) were prospectively enrolled into this study and retrospectively analyzed. Using qualitative and quantitative methods, we were able to differentiate between benign and malignant LNs with high sensitivity, specificity, positive and negative predictive values, and accuracy (85.71, 81.82, 83.33, 84.38, and 83.82% vs. 91.43, 72.73, 78.05, 88.89, and 82.35%, respectively). Conclusions: EBUS elastography is potentially capable of further differentiating between benign and malignant LNs. These proposed qualitative and quantitative methods might be useful tools for describing EBUS elastography during EBUS-TBNA.

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Section: Discussionmentioning

confidence: 99%

Section: Ebus Characteristics Of B-mode and Vascular Patternsmentioning

confidence: 99%

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Endobronchial Ultrasound Elastography for Evaluation of Intrathoracic Lymph Nodes: A Pilot Study

Sun

Zheng²,

Mao³

et al. 2017

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“…A multivariate analysis determined that four of the six characteristics were independent predictors of metastasis (round shape, distinct margin, heterogeneous echogenicity and presence of coagulation necrosis sign). Wang et al found five independent predictive factors for lymph node metastasis when they assessed 459 metastatic lymph nodes in 298 lung cancer patients and 176 reactive lymph nodes in 90 patients with non‐specific inflammation . However, both these studies were retrospective analyses of lymph node appearance, and pathological confirmation of a benign diagnosis was not undertaken.…”

mentioning

confidence: 99%

“…Wang et al found five independent predictive factors for lymph node metastasis when they assessed 459 metastatic lymph nodes in 298 lung cancer patients and 176 reactive lymph nodes in 90 patients with non-specific inflammation. 5 However, both these studies were retrospective analyses of lymph node appearance, and pathological confirmation of a benign diagnosis was not undertaken. In reality, for both staging and diagnosis of mediastinal lymph nodes, the key challenge is the confidence of accepting a benign pathology following needle sampling.…”

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confidence: 99%