Biomaterial Database

[Value of endobronchial ultrasound elastography in the diagnosis of mediastinal and hilar lymph node metastasis in lung cancer]. 2016

Haiyan He, and Xuedong Lu, and Hang Ma, and Jie Zhu, and Mao Huang

Department of Respiratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.

OBJECTIVE To assess the value of endobronchial ultrasound elastography in the diagnosis of mediastinal and hilar lymph node metastasis in lung cancer. METHODS A total of 40 patients with lung cancer underwent ultrasonic bronchoscope examination before operation. Elastography and standard endobronchial ultrasound (EBUS) of lymph nodes were performed before EBUS-guided transbronchial needle aspiration (EBUS-TBNA). The elastography characteristics was compared between benign and malignant lymph nodes. The diagnosis accuracy in malignant lymph nodes was also compared between the elastography and the standard EBUS. The value of the elastography was assessed in distinguishing the benign and malignant lymph nodes. RESULTS 1) The significant indicators of standard EBUS in diagnosis of malignant lymph nodes were hypoechonic nodes, uneven echo, distinct boundary and short diameter greater than 1 cm (all P<0.01). 2) There was significant difference in the elastosonography grading score between benign and malignant lymph nodes (P<0.01). 3) The elastography grading score was more sensitive and specific in determining the malignant lymph node than the standard EBUS criteria. The area under the receiver operating characteristic curve (AUC) was maximal when the elastography grading score was ≥2.5. The specificity, sensitivity, positive predictive value, negative predictive value of elastography grading score was 76.9%, 85.7%, 85.7% and 76.9% in distinguishing malignant and benign nodes. The overall accuracy of elastography grading score was 82.3%. The combination of elastography grading score, low echo, distinct boundary and short diameter greater than 1 cm showed the best diagnostic efficiency value. The AUC was 0.911. In distinguishing malignant and benign nodes, the specificity, sensitivity, positive predictive value, negative predictive value and accuracy of the combined indexes was 84.6%, 88.1%, 90.2%, and 81.5% respectively. The overall accuracy was 86.8%. CONCLUSIONS The endobronchial ultrasound elastography can effectively distinguish the mediastinal and hilar lymph node metastasis in lung cancer. The diagnosis accuracy of elastography in malignant lymph node is higher than that of standard EBUS criteria. The combination of elastosonography grading score and standard EBUS criteria can improve the diagnostic efficiency.

UI	MeSH Term	Description	Entries
D008175	Lung Neoplasms	Tumors or cancer of the LUNG.	Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008198	Lymph Nodes	They are oval or bean shaped bodies (1 - 30 mm in diameter) located along the lymphatic system.	Lymph Node,Node, Lymph,Nodes, Lymph
D008207	Lymphatic Metastasis	Transfer of a neoplasm from its primary site to lymph nodes or to distant parts of the body by way of the lymphatic system.	Lymph Node Metastasis,Lymph Node Metastases,Lymphatic Metastases,Metastasis, Lymph Node
D008482	Mediastinum	A membrane in the midline of the THORAX of mammals. It separates the lungs between the STERNUM in front and the VERTEBRAL COLUMN behind. It also surrounds the HEART, TRACHEA, ESOPHAGUS, THYMUS, and LYMPH NODES.
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189	Retrospective Studies	Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.	Retrospective Study,Studies, Retrospective,Study, Retrospective
D012680	Sensitivity and Specificity	Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)	Specificity,Sensitivity,Specificity and Sensitivity
D054459	Elasticity Imaging Techniques	Non-invasive imaging methods based on the mechanical response of an object to a vibrational or impulsive force. It is used for determining the viscoelastic properties of tissue, and thereby differentiating soft from hard inclusions in tissue such as microcalcifications, and some cancer lesions. Most techniques use ultrasound to create the images - eliciting the response with an ultrasonic radiation force and/or recording displacements of the tissue by Doppler ultrasonography.	ARFI Imaging,Acoustic Radiation Force Impulse Imaging,Elastograms,Elastography,Magnetic Resonance Elastography,Sonoelastography,Tissue Elasticity Imaging,Vibro-Acoustography,ARFI Imagings,Elasticity Imaging Technique,Elasticity Imaging, Tissue,Elasticity Imagings, Tissue,Elastogram,Elastographies,Elastographies, Magnetic Resonance,Elastography, Magnetic Resonance,Imaging Technique, Elasticity,Imaging Techniques, Elasticity,Imaging, ARFI,Imaging, Tissue Elasticity,Imagings, ARFI,Imagings, Tissue Elasticity,Magnetic Resonance Elastographies,Resonance Elastographies, Magnetic,Resonance Elastography, Magnetic,Sonoelastographies,Technique, Elasticity Imaging,Techniques, Elasticity Imaging,Tissue Elasticity Imagings,Vibro Acoustography,Vibro-Acoustographies
D020680	Bronchoscopes	Endoscopes for the visualization of the interior of the bronchi.	Bronchoscope