scholarly journals Endobronchial ultrasound elastography strain ratio for mediastinal lymph node diagnosis

2015 ◽  
Vol 49 (4) ◽  
pp. 334-340 ◽  
Author(s):  
Ales Rozman ◽  
Mateja Marc Malovrh ◽  
Katja Adamic ◽  
Tjasa Subic ◽  
Viljem Kovac ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Strain Ratio ◽  
Ultrasound Elastography ◽  
Endobronchial Ultrasound ◽  
Lung Tumour ◽  
Mediastinal Lymph Nodes ◽  
Ratio Measurement ◽  
Mediastinal Staging

AbstractBackground.Ultrasound elastography is an imaging procedure that can assess the biomechanical characteristics of different tissues. The aim of this study was to define the diagnostic value of the endobronchial ultrasound (EBUS) elastography strain ratio of mediastinal lymph nodes in patients with a suspicion of lung cancer. The diagnostic values of the strain ratios were compared with the EBUS brightness mode (B-mode) features of selected mediastinal lymph nodes and with their cytological diagnoses.Patients and methods.This prospective, single-centre study enrolled patients with an indication for biopsy and mediastinal staging after a non-invasive diagnostic workup of a lung tumour. EBUS with standard B-mode evaluation and elastography with strain ratio measurement were performed before endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Results.Thirty-three patients with 80 suspicious mediastinal lymph nodes were included. Malignant infiltration was confirmed in 34 (42.5%) lymph nodes. The area under the receiver operating characteristic curve for the strain ratio was 0.87 (p< 0.0001). At a strain ratio ≥ 8, the accuracy for malignancy prediction was 86.25% (sensitivity 88.24%, specificity 84.78%, positive predictive value [PPV] 81.08%, negative predictive value [NPV] 90.70%). The strain ratio is more accurate than conventional B-mode EBUS modalities for differentiating between malignant and benign lymph nodes.Conclusions.EBUS-guided elastography with strain ratio assessment can distinguish malignant from benign mediastinal lymph nodes with greater accuracy than conventional EBUS modalities. This new method may reduce the number of mediastinal EBUS-TBNAs and thus reduce the invasiveness and expense of mediastinal staging in patients with non-small lung cancer (NSCLC).

scholarly journals The role of endobronchial ultrasound elastography in the diagnosis of mediastinal lymph nodes

2017 ◽  
Vol 11 (3) ◽  
pp. 238 ◽  
Author(s):  
AdelS Bediwy ◽  
MohamedS Hantira ◽  
Dalia El Sharawy ◽  
Ayman El Saqa
Keyword(s):  
Lymph Nodes ◽  
Ultrasound Elastography ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymph Nodes

Endobronchial ultrasound-guided transbronchial needle aspiration versus cervical mediastinoscopy in lung cancer diagnosis and mediastinal staging: A retrospective comparison study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20066-e20066
Author(s):  
Rong Zhang ◽  
Yuxiang Ma ◽  
Guoliang Xu ◽  
Xiaoyan Gao ◽  
Guangyu Luo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Disease Diagnosis ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Lung Cancers ◽  
Mediastinal Staging ◽  
Study Results

e20066 Background: Invasive mediastinal lymph node staging is essential for resectable lung cancers. This retrospective study compares the diagnosis yield of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and cervical mediastinoscopy (CMS). Methods: Consecutive patients were analyzed from Jan 2009 to March 2016. Only pathologically confirmed results were accepted, and systematic mediastinal lymphadenectomy (SML) were used as the standard. The disease diagnosis and N stagingaccuracywere compared in this study. Results: 103 EBUS-TBNA patients and 232 CMS patients were included, 1014 mediastinal lymph nodes were biopsied in lung cancer patients. In per case analysis, there was no significant differences between EBUS-TBNA and CMS in disease diagnosis accuracy (89.4% vs. 81.2%, P = 0.097), and no significant difference in N staging accuracy (75.0% vs. 78.3%, P = 0.629). However, EBUS-TBNA had significantly higher disease diagnosis sensitivity than CMS (82.4% vs. 47.6%, P < 0.001). In lymph nodes diagnosis comparison (station #2, #4 and #7), both EBUS-TBNA and CMS showed very high accuracy, sensitivity, and specificity (94.7% vs. 99.6%, 88.6% vs. 94.8%, 97.2% vs. 100%), however CMS were slightly better. Positive lymph nodes had longer major and minor axes than negative nodes, and the positive rateswere as high as 59.2% in lymph nodes with a minor axis measuring ≥21mm. More complications and injuries were found in patients receiving CMS. Conclusions: For clinically suspected lung cancers, both EBUS-TBNA and CMS are favorable options for invasive mediastinal staging. EBUS-TBNA may be preferred for its higher disease diagnosis sensitivity and fewer complications.

scholarly journals Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Cytological Smears and Cell Blocks: A Single-Institution Experience

Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 19 ◽  
Author(s):  
Marius Žemaitis ◽  
Greta Musteikienė ◽  
Skaidrius Miliauskas ◽  
Darius Pranys ◽  
Raimundas Sakalauskas
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Medical Documentation ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration

Background and Objective: Endobronchial ultrasound (EBUS) is a minimally invasive endobronchial technique, which uses ultrasound along with a bronchoscope to visualize the airway wall and structures that are adjacent to it. Indications for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are samplings of mediastinal, hilar lymph nodes, and tumors adjacent to airway walls. EBUS-TBNA has been used in our clinic since 2009. The aim of the study is to evaluate the sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy of cytological and histological specimens, and the safety of EBUS-TBNA in an unselected patient population that has been referred to our hospital. Materials and Methods: We have retrospectively analyzed the medical documentation of 215 patients who had EBUS-TBNA performed in our clinic from April 2009 to February 2014. Results: There were 215 patients who underwent EBUS-TBNA. A total of 296 lymph nodes were sampled. EBUS-TBNA was diagnostic in 176 (81.9%) cases of cytological, 147 (68.4%) cases of histological, and 191 (88.9%) cases of the combined evaluation. In the lung cancer patients, EBUS-TBNA cytology had a sensitivity of 72.9% and histology of 72.9%, and in the sarcoidosis group, it had a cytology of 55.8% and histology of 64.5%. As all positive cytology and histology specimens were assumed to be true positive, specificity and positive predictive value (PPV) were 100%. The sensitivity and diagnostic accuracy was significantly higher when cytology and histology specimens were combined, compared with cytology or histology results evaluated separately (p < 0.05) (for lung cancer 84.1% and for sarcoidosis 78.8%). The sensitivity and diagnostic accuracy of EBUS-TBNA procedures increased significantly over time, with increased experience. There were no complications with EBUS-TBNA in our clinical practice. Conclusions: EBUS-TBNA had a high diagnostic yield and was safe in the diagnosis of lung cancer and sarcoidosis. It was most informative when cytology and histology were combined. The informative value of EBUS-TBNA histology increased with our experience.

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