Endobronchial Ultrasound Multimodal Imaging for the Diagnosis of Intrathoracic Lymph Nodes

Respiration ◽  
2021 ◽  
pp. 1-11
Author(s):  
Xinxin Zhi ◽  
Junxiang Chen ◽  
Lei Wang ◽  
Fangfang Xie ◽  
Xiaoxuan Zheng ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Multimodal Imaging ◽  
Single Mode ◽  
Diagnostic Value ◽  
Diagnostic Methods ◽  
Endobronchial Ultrasound ◽  
Diagnostic Efficiency ◽  
Validation Group ◽  
Model Group ◽  
Structure Heterogeneity

<b><i>Background:</i></b> Endobronchial ultrasound (EBUS) imaging is valuable in diagnosing intrathoracic lymph nodes (LNs), but there has been little analysis of multimodal imaging. This study aimed to comprehensively compare the diagnostic performance of single and multimodal combinations of EBUS imaging in differentiating benign and malignant intrathoracic LNs. <b><i>Methods:</i></b> Subjects from July 2018 to June 2019 were consecutively enrolled in the model group and July 2019 to August 2019 in the validation group. Sonographic features of three EBUS modes were analysed in the model group for the identification of malignant LNs from benign LNs. The validation group was used to verify the diagnostic efficiency of single and multimodal diagnostic methods built in the model group. <b><i>Results:</i></b> 373 LNs (215 malignant and 158 benign) from 335 subjects and 138 LNs (79 malignant and 59 benign) from 116 subjects were analysed in the model and validation groups, respectively. For single mode, elastography had the best diagnostic value, followed by grayscale and Doppler. The corresponding accuracies in the validation group were 83.3%, 76.8%, and 71.0%, respectively. Grayscale with elastography had the best diagnostic efficiency of multimodal methods. When at least two of the three features (absence of central hilar structure, heterogeneity, and qualitative elastography score 4–5) were positive, the sensitivity, specificity, and accuracy in the validation group were 88.6%, 78.0%, and 84.1%, respectively. <b><i>Conclusions:</i></b> In both model and validation groups, elastography performed the best in single EBUS modes, as well as grayscale combined with elastography in multimodal imaging. Elastography alone or combined with grayscale are feasible to help predict intrathoracic benign and malignant LNs.

scholarly journals Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Huang ◽  
Yuan Lu ◽  
Xihua Wang ◽  
Xiaoli Zhu ◽  
Ping Li ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Endobronchial Ultrasound ◽  
Lymph Node Status ◽  
Transbronchial Needle Aspiration ◽  
Hilar Lymph Node ◽  
Malignant Lymph Nodes

Abstract Background Endobronchial ultrasound (EBUS) elastography has been used in EBUS-guided transbronchial needle aspiration (EBUS-TBNA) to identify malignant lymph nodes based on tissue stiffness. Rapid onsite cytological evaluation (ROSE) has been widely utilized for onsite evaluation of sample adequacy and for guiding sampling during EBUS-TBNA. The aim of this study was to investigate the diagnostic value of combined EBUS elastography and ROSE in evaluating mediastinal and hilar lymph node status. Methods Retrospective chart review was performed from December 2018 to September 2020. Patient demographics, EBUS elastography scores, and ROSE, pathologic, and clinical outcome data were collected. The EBUS elastography scores were classified as follows: Type 1, predominantly nonblue; Type 2, partially blue and partially nonblue; and Type 3, predominantly blue. A receiver operating characteristic curve was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for evaluation of malignant lymph nodes among the EBUS elastography, ROSE, and EBUS combined with ROSE groups. Results A total of 245 patients (345 lymph nodes) were included. The sensitivity and specificity of the EBUS elastography group for the diagnosis of malignant lymph nodes were 90.51% and 57.26%, respectively. The sensitivity and specificity in the ROSE group were 96.32% and 79.05%, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of EBUS elastography combined with ROSE were 86.61%, 92.65%, 11.78, and 0.14, respectively, and the area under the curve was 0.942. Conclusions Combining EBUS elastography and ROSE significantly increased the diagnostic value of EBUS-TBNA in evaluating mediastinal and hilar lymph node status compared to each method alone.

Diagnostic Value of Elastography and Endobronchial Ultrasound in the Study of Hilar and Mediastinal Lymph Nodes

2019 ◽  
Vol 26 (3) ◽  
pp. 184-192 ◽  
Author(s):  
María Hernández Roca ◽  
Javier Pérez Pallarés ◽  
David Prieto Merino ◽  
María del Mar Valdivia Salas ◽  
Jose García Solano ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Diagnostic Value ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymph Nodes

scholarly journals Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

2021 ◽  
Author(s):  
Jing Huang ◽  
Yuan Lu ◽  
Xihua Wang ◽  
Xiaoli Zhu ◽  
Ping Li ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Transbronchial Needle Aspiration ◽  
Sensitivity Specificity ◽  
Malignant Lymph Nodes

Abstract Background: Endobronchial ultrasound (EBUS) elastography has been applied in EBUS-guided transbronchial needle aspiration (EBUS-TBNA) to identify malignant lymph nodes based on the tissue stiffness. Rapid onsite cytological evaluation (ROSE) has been widely used for onsite evaluation of the adequacy of the samples and guiding the sampling during EBUS-TBNA. The aim of the study is to investigate the diagnostic value of combined EBUS elastography and ROSE in evaluating of mediastinal and hilar lymph nodes status.Methods: A retrospective chart review was performed from December 2018 to September 2020. Patients’ demographic, EBUS elastography score, ROSE, pathologic and clinical outcomes were collected. The EBUS elastography scores were classified as follows: Type 1, predominantly non-blue; Type 2, partially blue and partially non-blue; Type 3, predominantly blue. Receiver operating characteristic (ROC) curve was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio among EBUS elastography, ROSE, and EBUS combined with ROSE groups for evaluation of malignant lymph nodes.Results: A total of 247 patients (345 lymph nodes) were included in our study. The sensitivity and specificity of EBUS elastography group in the diagnosis of malignant lymph nodes were 90.51% and 57.26%, respectively. The sensitivity and specificity in the ROSE alone group were 96.32% and 79.05%, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of EBUS elastography combined with ROSE group were 86.61%, 92.65%, 11.78, and 0.14, respectively, and the area under curve was 0.942.Conclusions: The combination of EBUS elastography and ROSE significantly increased the diagnostic value of EBUS-TBNA in evaluating mediastinal and hilar lymph nodes status.

scholarly journals Abdominal tuberculosis

2021 ◽  
pp. 37-44
Author(s):  
O.D. Nikolaeva
Keyword(s):  
Lymph Nodes ◽  
High Sensitivity ◽  
Abdominal Tuberculosis ◽  
Diagnostic Value ◽  
Diagnostic Methods ◽  
Mesenteric Lymph Nodes ◽  
Ileocecal Region ◽  
Infected People ◽  
Mesenteric Lymph ◽  
Abdominal Organs

ABSTRACT. The problem of detecting and diagnosing abdominal tuberculosis (TB) remains difficult. Recently in Ukraine there has been an increase in extrapulmonary TB, including abdominal TB. In modern conditions, this localization of TB is a manifestation of a generalized process in HIV-infected people. The most commonly diagnosed lesions of the lymphatic system and the peritoneum. The liver and spleen in abdominal TB is affected in every third case (32.3 %). In most patients, TB of the abdominal organs develops as a result of lymph-hematogenous dissemination from the primary focus, progresses through contact from the mesenteric lymph nodes to the peritoneum and intestines. According to statistics, TB of the mesenteric lymph nodes is most often diagnosed (70 %), the ileocecal region and the peritoneum are affected in 12 % of cases. The clinical picture of abdominal TB is polymorphic, there are no pathognomonic symptoms, therefore, the diagnosis of damage to the abdominal organs is the most difficult in the field of phthisiology. Diagnostic methods that are used: X-ray examination of the small intestine with a contrast agent, irrigoscopy, ultrasonography, computed tomography (CT), laparoscopy and laparotomy with sampling of material for morphological and bacteriological researches. The diagnostic value of CT with bolus enhancement is quite high: sensitivity is 95 %, specificity is 67.5 %. Given the difficulty of confirming the diagnosis of TB, in the case when the diagnosis is not confirmed culturally or histologically, and there is a reasonable suspicion of a specific lesion, which is based on clinical, endoscopic and radiological data, it is recommended to prescribe empirical treatment. Most patients respond positively to anti-TB treatment within 2 weeks. A clinical case of abdominal TB in an HIV-infected patient is described in this article.

scholarly journals Deep learning with convex probe endobronchial ultrasound multimodal imaging: A validated tool for automated intrathoracic lymph nodes diagnosis

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Wenrui Dai ◽  
Jiayuan Sun ◽  
Jin Li ◽  
Xinxin Zhi ◽  
Junxiang Chen ◽  
...  
Keyword(s):  
Deep Learning ◽  
Lymph Nodes ◽  
Multimodal Imaging ◽  
Endobronchial Ultrasound

scholarly journals Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in various lung diseases

2015 ◽  
Vol 41 (5) ◽  
pp. 410-414 ◽  
Author(s):  
Mediha Gonenc Ortakoylu ◽  
Sinem Iliaz ◽  
Ayse Bahadir ◽  
Asuman Aslan ◽  
Raim Iliaz ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Lung Disease ◽  
Diagnostic Value ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Pulmonary Medicine ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Male Patients ◽  
Granulomatous Diseases

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of lung disease, and its use is increasing worldwide. It has been used as a means of diagnosing lung cancer in its initial stages, and there are data supporting its use for the diagnosis of benign lung disease. The aim of this study was to share our experience with EBUS-TBNA and discuss its diagnostic value. Methods: We retrospectively analyzed the results related to 159 patients who underwent EBUS-TBNA at our pulmonary medicine clinic between 2010 and 2013. We recorded the location and size of lymph nodes seen during EBUS. Lymph nodes that appeared to be affected on EBUS were sampled at least twice. We recorded the diagnostic results of EBUS-TBNA and (for cases in which EBUS-TBNA yielded an inconclusive diagnosis) the final diagnoses after further investigation and follow-up. Results: We evaluated 159 patients, of whom 89 (56%) were male and 70 (44%) were female. The mean age was 54.6 ± 14.2 years among the male patients and 51.9 ± 11.3 years among the female patients. Of the 159 patients evaluated, 115 (84%) were correctly diagnosed by EBUS. The diagnostic accuracy of EBUS-TBNA was 83% for benign granulomatous diseases and 77% for malignant diseases. Conclusions: The diagnostic value of EBUS-TBNA is also high for benign pathologies, such as sarcoidosis and tuberculosis. In patients with mediastinal disorders, the use of EBUS-TBNA should be encouraged, primarily because it markedly reduces the need for mediastinoscopy.

scholarly journals The diagnostic value of contrast-enhanced ultrasound for cervical tuberculous lymphadenitis

2022 ◽  
pp. 1-11
Author(s):  
Dan Zhao ◽  
Ning He ◽  
Ya-Qin Shao ◽  
Xiu-Lei Yu ◽  
Jie Chu ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
High Specificity ◽  
Diagnostic Value ◽  
Diagnostic Sensitivity ◽  
Tuberculous Lymphadenitis ◽  
Diagnostic Efficiency ◽  
Contrast Enhanced Ultrasound ◽  
Imaging Findings ◽  
Contrast Enhanced ◽  
Heterogeneous Enhancement

OBJECTIVE: To investigate the value of contrast-enhanced ultrasound (CEUS) for the diagnosis of cervical tuberculous lymphadenitis (CTL). METHODS: The cohort study included 203 consecutive patients diagnosed with cervical lymph node. Before pathological or laboratory confirmation, all patients underwent CEUS examination, and the imaging findings were analyzed afterward. The diagnostic efficiency of the CEUS imaging findings of CTL was evaluated. RESULTS: Nighty-seven patients of the 203 (47.8%) were pathologically or laboratory confirmed with a CTL diagnosis while the remainder (52.2%) were diagnosed with non-tuberculous lymphadenitis. Regarding the imaging findings of CEUS, it was more common in CTL patients to find a pattern of heterogeneous enhancement inside the lymph nodes relative to non-tuberculous patients [81.44% (79/97) vs 15.09% (16/106), P <  0.01]. The sensitivity of the feature in diagnosis for CTL was 81.44% and the specificity was 84.91%, resepectively. Furthermore, a pattern of peripheral rim-like enhancement had been notable in CTL patients compared with non-tuberculous patients [86.60% (84/97) vs 12.26% (13/106), P <  0.01], associating with a diagnostic sensitivity of 86.60% and a specificity of 87.74% . When it came to the combination of both imaging findings mentioned above, the features were more prominent in CTL patients than compared with non-tuberculous patients [74.23% (72/97) vs 5.66% (6/106), P <  0.01], with a diagnostic sensitivity of 74.23% and a high specificity of 94.34% . Regarding area under curve (AUC) for the ROC analysis, the feature of internal heterogeneous enhancement, peripheral rim-like enhancement, and both features were 0.832, 0.872, and 0.843. CONCLUSIONS: CEUS patterns of heterogeneous enhancement and peripheral rim-like enhancement of lymph nodes are helpful characteristics for the diagnosis of CTL.

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