1.Clinical Value of Endobronchial Ultrasound Findings for Predicting Nodal Metastasis in Patients with Suspected Lymphadenopathy: A Prospective Study.
Byung Woo JHUN ; Sang Won UM ; Gee Young SUH ; Man Pyo CHUNG ; Hojoong KIM ; O Jung KWON ; Joungho HAN ; Kyung Jong LEE
Journal of Korean Medical Science 2014;29(12):1632-1638
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.
Aged
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Bronchi
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Endoscopic Ultrasound-Guided Fine Needle Aspiration/*methods
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Endosonography/*methods
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Female
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Humans
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Lymph Nodes/*pathology/ultrasonography
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Lymphatic Diseases/*pathology/ultrasonography
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Lymphatic Metastasis
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Male
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Middle Aged
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Prospective Studies
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Reproducibility of Results
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Sensitivity and Specificity
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Thoracic Neoplasms/*pathology/*secondary/ultrasonography