Clinical Value of Endobronchial Ultrasound Findings for Predicting Nodal Metastasis in Patients with Suspected Lymphadenopathy: A Prospective Study.
10.3346/jkms.2014.29.12.1632
- Author:
Byung Woo JHUN
1
;
Sang Won UM
;
Gee Young SUH
;
Man Pyo CHUNG
;
Hojoong KIM
;
O Jung KWON
;
Joungho HAN
;
Kyung Jong LEE
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Armed Forces Capital Hospital, Seongnam, Korea.
- Publication Type:Original Article
- Keywords:
Endoscopic Ultrasound;
Needle Aspiration;
Lymph Nodes, Lymphatic Metastasis;
Prediction
- MeSH:
Aged;
Bronchi;
Endoscopic Ultrasound-Guided Fine Needle Aspiration/*methods;
Endosonography/*methods;
Female;
Humans;
Lymph Nodes/*pathology/ultrasonography;
Lymphatic Diseases/*pathology/ultrasonography;
Lymphatic Metastasis;
Male;
Middle Aged;
Prospective Studies;
Reproducibility of Results;
Sensitivity and Specificity;
Thoracic Neoplasms/*pathology/*secondary/ultrasonography
- From:Journal of Korean Medical Science
2014;29(12):1632-1638
- CountryRepublic of Korea
- Language:English
-
Abstract:
We evaluated whether sonographic findings can provide additional diagnostic yield in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), and can more accurately predict nodal metastasis than chest computed tomography (CT) or positron emission tomography (PET)/CT scans. EBUS-TBNA was performed in 146 prospectively recruited patients with suspected thoracic lymph node involvement on chest CT and PET/CT from June 2012 to January 2013. Diagnostic yields of EBUS finding categories as a prediction model for metastasis were evaluated and compared with findings of chest CT, PET/CT, and EBUS-TBNA. In total, 172 lymph nodes were included in the analysis: of them, 120 were malignant and 52 were benign. The following four EBUS findings were predictive of metastasis: nodal size > or =10 mm, round shape, heterogeneous echogenicity, and absence of central hilar structure. A single EBUS finding did not have sufficient diagnostic yield; however, when the lymph node had any one of the predictive factors on EBUS, the diagnostic yields for metastasis were higher than for chest CT and PET/CT, with a sensitivity of 99.1% and negative predictive value of 83.3%. When any one of predictive factors is observed on EBUS, subsequent TBNA should be considered, which may provide a higher diagnostic yield than chest CT or PET/CT.
