Endobronchial ultrasound elastography for differentiating benign and malignant lymph nodes

• Verfasst von: Gompelmann, Daniela [VerfasserIn]
• Verfasst von: Kontogianni, Konstantina [VerfasserIn]
• Verfasst von: Sarmand, Nilab [VerfasserIn]
• Verfasst von: Kaukel, Philine [VerfasserIn]
• Verfasst von: Krisam, Johannes [VerfasserIn]
• Verfasst von: Eberhardt, Ralf [VerfasserIn]
• Verfasst von: Herth, Felix [VerfasserIn]
• Titel: Endobronchial ultrasound elastography for differentiating benign and malignant lymph nodes
• Verf.angabe: Daniela Gompelmann, Konstantina Kontogianni, Nilab Sarmand, Philine Kaukel, Johannes Krisam, Ralf Eberhardt, Felix J.F. Herth
• Jahr: 2020
• Umfang: 5 S.
• Fussnoten: Gesehen am 13.01.2021
• Titel Quelle: Enthalten in: Respiration
• Ort Quelle: Basel : Karger, 1944
• Jahr Quelle: 2020
• Band/Heft Quelle: 99(2020), 9, Seite 779-783
• ISSN Quelle: 1423-0356
• DOI: doi:10.1159/000509297
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1744481164

Abstract

Background: Endobronchial ultrasound elastography that provides information on tissue stiffness may help distinguish malignant from benign mediastinal and hilar lymph nodes. Objectives: In this prospective trial, we assessed the diagnostic value of elastographic images and the interobserver agreement in its evaluation. Method: Elastographic images from 77 lymph nodes in 65 patients were reviewed by 3 pneumologists. The elastographic image was classified based on the predominant colour: predominantly green, intermediary, and predominantly blue. With 2 or 3 interobserver matches, the corresponding elastographic image was correlated with the pathological result obtained from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and/or other invasive procedures. Results: All 3 reviewers had agreement in classifying elastographic images in 45% (35/77). Overall, the interobserver agreement among the 3 readers for classifying elastographic pattern was found to be moderate (Fleiss Kappa index = 0.519; 95% CI = [0.427; 0.611]). On cytological/histological evaluation, 55 lymph nodes were malignant and 22 were benign. In classifying “green” as benign and “blue” as malignant, the sensitivity and specificity were 71% (95% CI = [54%; 85%]) and 67% (95%-CI = [35%; 90%]), respectively. Conclusions: Elastography will not replace invasive EBUS-TBNA due to a moderate interobserver agreement and insufficient sensitivity and specificity. However, elastography will, maybe, present an additional feature to identify malignant lymph nodes in the context of clinical, radiological, and cytological results.