RT Journal Article
SR Electronic
T1 EndoBronchial ultrasound: Morphological predictors of benign disease
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3556
VO 44
IS Suppl 58
A1 Pratibha Gogia
A1 Tabassum Insaaf
A1 Tom Wilkinson Zoumot
A1 Affroditi Baotau
A1 William McNaulty
A1 Pallav L. Shah
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P3556.abstract
AB Rationale: Endobronchial ultrasound (EBUS) has cemented its usefulness in the diagnosis and staging of mediastinal lymph nodes and it significantly obviates the requirement of mediastinoscopy. This study was performed to evaluate whether sonographic features could predict for benign diseases and hence avoid further invasive investigations.Objective To study the utility of EBUS morphology of mediastinal lymph nodes for predicting benign cytology in a prospective observational study.Method Morphological characteristics of mediastinal lymph nodes were recorded in all lymph nodes sampled during EBUS. Lymph nodes were evaluated for 5 parameters; size, shape, margins, echogenic appearance and the presence of a central blood vessel. These ultrasonographic characteristics were correlated with the final diagnosis.Results 402 (237 males,165 females) patients underwent EBUS. The final diagnosis of malignant disease was in 244 (60.6%) of subjects and of benign or reactive lymph nodes in 153 (38.05% ) of patients and 5 patients (7 nodes sampled) were lost to follow up and final correlation could not be done. A total of 740 nodes were sampled. In 463 were ( 62.6%) malignant were identified whereas 270( 36.5%) nodes no malignant cells were identified. On Bivariate analysis small size, triangular shape and the presence of central vessel were predictive of a benign aetiology for the mediastinal lymph nodes. As per the final model, predictive probability of 0.811 (CI 0.72-0. 91s) was found if Ln size is <10 cm and central vessel is present.Conclusion: Sonographic appearances of lymph nodes improves the negative predictive value of EBUS and reduce the need for investigations such as mediastinoscopy.