The role of endobronchial ultrasound elastography in the diagnosis of mediastinal and hilar lymph nodes

Ye Gu, Hong Shi, Chunxia Su, Xiaoxia Chen, Shijia Zhang, Wei Li, Fengying Wu, Guanghui Gao, Hao Wang, Haiqing Chu, Caicun Zhou, Fei Zhou, Shengxiang Ren

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been widely used for diagnosis and mediastinal lymph nodes staging in patients with suspicious lung cancer. Ultrasound elastography is a novel sonographical technique that can evaluate tissue compressibility. The aim of the present study was to investigate the diagnostic yield of elastography for differentiating malignant and benign mediastinal lymph nodes. Conventional EBUS B-mode features, including size, shape, border distinction, echogenicity, central hilar structure with central blood vessel and coagulation necrosis were also evaluated. The ultrasonic features were compared with the pathological results from EBUS-TBNA. 133 lymph nodes in 60 patients were assessed. Elastography displayed the highest area under the curve (AUC) (type 3 versus type 1: AUC, 0.825; 95% confidence interval [CI], 0.707- 0.910) with an impressive sensitivity (100%) and an acceptable specificity (65%). The combined model covering the four positive criteria (elastography, heterogeneity, size, and shape) showed that the odds ratio for malignance is 9.44 with a 95% CI of 3.99 to 22.32 (p < 0.0001). The combined model was superior to elastography alone (AUC, 0.851; sensitivity, 89.89%; specificity, 72.73%; p < 0.0001). This prospective study showed that elastography is a feasible technique for classifying mediastinal lymph nodes, especially in combination with conventional EBUS imaging.

Original languageEnglish (US)
Pages (from-to)89194-89202
Number of pages9
JournalOncotarget
Volume8
Issue number51
DOIs
StatePublished - 2017

Bibliographical note

Funding Information:
This study was supported in part by grants from Medical Guide Program of Shanghai Science and Technology Committee (No. 14411962900), Outstanding Young Doctor Program of Shanghai Municipal Commission of Health and Family Planning (No. XYQ2013097) and Shanghai Sailing Program (16YF1409600).

Keywords

  • Diagnosis
  • EBUS-TBNA
  • Elastography
  • Lung cancer
  • Lymph nodes

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