Agreement of Mediastinal Lymph Node Size Between Computed Tomography and Endobronchial Ultrasonography: A Study of 617 Patients

Dhooria, Sahajal; Agarwal, Ritesh; Aggarwal, Ashutosh N.; Gupta, Nalini; Gupta, Dheeraj; Behera, Digambar

doi:10.1016/j.athoracsur.2015.02.055

Cited by 16 publications

(15 citation statements)

References 21 publications

(19 reference statements)

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“…Increased MLN size has been strongly linked to more advanced stages of malignancy and greater mortality (43,44). Fourth, there is abundant evidence in health and disease that noninvasive CT assessment of MLN enlargement correlates fairly well with more invasive techniques such as endobronchial ultrasound measurements (21,45). Thus, preliminary CT evaluation is almost always used to guide MLN sampling and tissue procurement for diagnosis and planning therapy.…”

Section: Discussionmentioning

confidence: 99%

Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation

Adegunsoye

Oldham

Bonham

et al. 2019

Am J Respir Crit Care Med

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Section: Discussionmentioning

confidence: 99%

Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation

Adegunsoye

Oldham

Bonham

et al. 2019

Am J Respir Crit Care Med

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“…[15] In our study, we accepted lymph nodes as a lymphadenopathy according to this definition. To determine the location, size, and the presence of cystic-necrotic parts of the lymph nodes, each lesion was interpreted on T2-weighted images initially.…”

Section: Methodsmentioning

confidence: 99%

Apparent Diffusion Coefficient Measurement in Mediastinal Lymphadenopathies: Differentiation between Benign and Malignant Lesions

Ustabaşıoğlu

Samancı

Alış

et al. 2017

Journal of Clinical Imaging Science

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Objectives:We aimed to prospectively assess the diagnostic value of apparent diffusion coefficient (ADC) measurement in the differentiation of benign and malignant mediastinal lymphadenopathies.Materials and Methods:The study included 63 consecutive patients (28 women, 35 men; mean age 59.3 years) with 125 mediastinal lymphadenopathies. Echoplanar diffusion-weighted magnetic resonance imaging of the mediastinum was performed with b-factors of 0 and 600 mm2/s before mediastinoscopy and mediastinotomy, and ADC values were measured. The ADC values were compared with the histological results, and statistical analysis was done. P < 0.05 was considered statistically significant.Results:The mean ADC value of malignant mediastinal lymphadenopathy (1.030 ± 0.245 × 10−3 mm2/s) was significantly lower (P < 0.05) when compared to benign lymphadenopathies (1.571 ± 0.559 × 10−3 mm2/s). For differentiating malignant from benign mediastinal lymphadenopathy, the best result was obtained when an ADC value of 1.334 × 10−3 mm2/s was used as a threshold value; area under the curve 0.848, accuracy 78.4%, sensitivity 66%, specificity of 86%, positive predictive value 76.7%, and negative predictive value of 79.2%. Interobserver agreement was excellent for ADC measurements.Conclusions:ADC measurements could be considered an important supportive method in differentiating benign from malignant mediastinal lymphadenopathies.

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“…EBUS procedures were performed on an outpatient basis, according to the standard protocol described previously. [ 11 ] The subjects were premedicated with atropine (0.6 mg) and promethazine (25 mg) intramuscularly followed by nebulization with 4% lidocaine solution. Two actuations of 10% lignocaine spray were applied to the oropharynx and subjects were then placed in the supine position.…”

Section: Methodsmentioning

confidence: 99%

Yield of new versus reused endobronchial ultrasound-guided transbronchial needle aspiration needles: A retrospective analysis of 500 patients

et al. 2016

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Background:Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) requires a dedicated needle for aspiration of mediastinal lesions. There is no data on reuse of these needles.Methods:This is a retrospective study of patients who underwent EBUS-TBNA with either new or reused EBUS-TBNA needles. The needles were reused after thorough cleaning with filtered water and organic cleaning solution, disinfection with 2.4% glutaraldehyde solution followed by ethylene oxide sterilization. The yield of EBUS-TBNA was compared between the two groups.Results:A total of 500 EBUS-TBNA procedures (351 new, 149 reused needles) were performed. The baseline characteristics were different in the two groups with suspected granulomatous disorders (sarcoidosis or tuberculosis) being significantly more common in the new compared to the reused needle group. Similarly, the median, interquartile range number of lymph node stations sampled, and the total number of passes were significantly higher in the new versus the reused needle group. The diagnostic yield was significantly higher with new needle as compared to reused needle (65.2% vs. 53.7%, P = 0.02). On multivariate logistic regression analysis, clinical suspicion of granulomatous disorders (odds ratio 1.86 [95% confidence interval, 1.20-2.87], P = 0.005) was the only predictor of diagnostic yield, after adjusting for the type of needle (new or reused), total number of passes and the number of lymph node stations sampled. No case of mediastinitis was encountered in either group.Conclusions:The yield of EBUS-TBNA might be similar with single reuse of needles as compared to new needles. However, reuse of needle should be performed only when absolutely necessary.

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Agreement of Mediastinal Lymph Node Size Between Computed Tomography and Endobronchial Ultrasonography: A Study of 617 Patients

Abstract: Despite a significant correlation between CT of the chest and EBUS for measuring the size of intrathoracic lymph nodes, the limits of agreement were fairly wide enough to be clinically acceptable for allowing the use of the two modalities interchangeably for this purpose.

Cited by 16 publications

References 21 publications

Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation

Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation

Apparent Diffusion Coefficient Measurement in Mediastinal Lymphadenopathies: Differentiation between Benign and Malignant Lesions

Yield of new versus reused endobronchial ultrasound-guided transbronchial needle aspiration needles: A retrospective analysis of 500 patients

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