Differentiating malignant and benign lymph nodes using endobronchial ultrasound elastography
Background/Purpose: Endobronchial ultrasound (EBUS) elastography is a new technique that provides information on tissue compressibility during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The purposes of this study were to evaluate the utility of EBUS elastography in...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-01-01
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| Series: | Journal of the Formosan Medical Association |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664618302754 |
| _version_ | 1818842596042080256 |
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| author | Ching-Kai Lin Kai-Lun Yu Lih-Yu Chang Hung-Jen Fan Yueh-Feng Wen Chao-Chi Ho |
| author_facet | Ching-Kai Lin Kai-Lun Yu Lih-Yu Chang Hung-Jen Fan Yueh-Feng Wen Chao-Chi Ho |
| author_sort | Ching-Kai Lin |
| collection | DOAJ |
| description | Background/Purpose: Endobronchial ultrasound (EBUS) elastography is a new technique that provides information on tissue compressibility during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The purposes of this study were to evaluate the utility of EBUS elastography in differentiating malignant and benign mediastinal lymph nodes (LNs) and to explore the factors that influence its accuracy. Methods: A retrospective chart review of patients who underwent EBUS-TBNA from October 2016 to July 2017 was performed. EBUS with conventional B-mode features and elastographic patterns were compared with the final pathology results or clinical follow-up. We used the following EBUS elastographic patterns for classification: type 1, predominantly non-blue (green, yellow and red); type 2, part blue, part non-blue; type 3, predominantly blue. The potential impacts of the characteristics of LNs, the underlying lung diseases and obtaining fibrotic components from EBUS-TBNA specimens were evaluated relative to the accuracy of EBUS elastography. Results: A total of 206 LNs from 94 patients were retrospectively evaluated. In classifying type 1 as ‘benign’ and type 3 as ‘malignant,’ the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rate were 90.6, 82.6, 71.6, 94.7 and 85.2%, respectively. The EBUS elastographic patterns had higher diagnostic yields and negative predictive values than conventional B-mode features. Logistic regression analysis revealed that central necrosis was a factor that influenced the accuracy of elastography in malignant LNs. The fibrotic component within benign LNs could cause an incorrect elastographic pattern. Conclusion: EBUS elastography is a valuable tool in discriminating benign and malignant mediastinal LNs. Keywords: Elastography, Endobronchial ultrasound-guided transbronchial needle, Mediastinal lymph node |
| first_indexed | 2024-12-19T04:44:29Z |
| format | Article |
| id | doaj.art-3001d12a65954d9b8948cd603c2e7ff9 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-19T04:44:29Z |
| publishDate | 2019-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-3001d12a65954d9b8948cd603c2e7ff92022-12-21T20:35:31ZengElsevierJournal of the Formosan Medical Association0929-66462019-01-011181436443Differentiating malignant and benign lymph nodes using endobronchial ultrasound elastographyChing-Kai Lin0Kai-Lun Yu1Lih-Yu Chang2Hung-Jen Fan3Yueh-Feng Wen4Chao-Chi Ho5Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, HsinChu, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, HsinChu, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, HsinChu, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, HsinChu, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Chutung Branch, Chutung, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, HsinChu, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. Department of Internal Medicine, National Taiwan University Hospital, 7, Chung-Shan South Road, 100, Taipei, Taiwan. Fax: +886 2 23582867.Background/Purpose: Endobronchial ultrasound (EBUS) elastography is a new technique that provides information on tissue compressibility during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The purposes of this study were to evaluate the utility of EBUS elastography in differentiating malignant and benign mediastinal lymph nodes (LNs) and to explore the factors that influence its accuracy. Methods: A retrospective chart review of patients who underwent EBUS-TBNA from October 2016 to July 2017 was performed. EBUS with conventional B-mode features and elastographic patterns were compared with the final pathology results or clinical follow-up. We used the following EBUS elastographic patterns for classification: type 1, predominantly non-blue (green, yellow and red); type 2, part blue, part non-blue; type 3, predominantly blue. The potential impacts of the characteristics of LNs, the underlying lung diseases and obtaining fibrotic components from EBUS-TBNA specimens were evaluated relative to the accuracy of EBUS elastography. Results: A total of 206 LNs from 94 patients were retrospectively evaluated. In classifying type 1 as ‘benign’ and type 3 as ‘malignant,’ the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rate were 90.6, 82.6, 71.6, 94.7 and 85.2%, respectively. The EBUS elastographic patterns had higher diagnostic yields and negative predictive values than conventional B-mode features. Logistic regression analysis revealed that central necrosis was a factor that influenced the accuracy of elastography in malignant LNs. The fibrotic component within benign LNs could cause an incorrect elastographic pattern. Conclusion: EBUS elastography is a valuable tool in discriminating benign and malignant mediastinal LNs. Keywords: Elastography, Endobronchial ultrasound-guided transbronchial needle, Mediastinal lymph nodehttp://www.sciencedirect.com/science/article/pii/S0929664618302754 |
| spellingShingle | Ching-Kai Lin Kai-Lun Yu Lih-Yu Chang Hung-Jen Fan Yueh-Feng Wen Chao-Chi Ho Differentiating malignant and benign lymph nodes using endobronchial ultrasound elastography Journal of the Formosan Medical Association |
| title | Differentiating malignant and benign lymph nodes using endobronchial ultrasound elastography |
| title_full | Differentiating malignant and benign lymph nodes using endobronchial ultrasound elastography |
| title_fullStr | Differentiating malignant and benign lymph nodes using endobronchial ultrasound elastography |
| title_full_unstemmed | Differentiating malignant and benign lymph nodes using endobronchial ultrasound elastography |
| title_short | Differentiating malignant and benign lymph nodes using endobronchial ultrasound elastography |
| title_sort | differentiating malignant and benign lymph nodes using endobronchial ultrasound elastography |
| url | http://www.sciencedirect.com/science/article/pii/S0929664618302754 |
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