Diagnostic value of endobronchial ultrasound image features: A specialized review

Abstract

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) technology is important in the diagnosis of intrathoracic benign and malignant lymph nodes (LNs). With the development of EBUS imaging technology, its role in noninvasive diagnosis, as a supplement to pathology diagnosis, has been given increasing attention in recent years. Many studies have explored qualitative and quantitative methods for the three EBUS modes, as well as a variety of multimodal analysis methods, to find the optimal method for the noninvasive diagnosis using EBUS for LNs. Here, we review and comment on the research methods and predictive diagnostic value, discuss the existing problems, and look ahead to the future application of EBUS imaging.

Role of invasive mediastinal nodal staging in survival outcomes of patients with non-small cell lung cancer and without radiologic lymph node metastasis: a retrospective cohort study

“…The current techniques for IMNS are not accurate enough to localise and/or detect such tiny lesions. 25 We have performed more than five thousands of endosonographic biopsy procedures for N2 nodes. However, the sensitivity of endosonographic biopsy in rN0 disease is only 49%.…”

Pneumonia, pleurisy, mediastinitis, and mediastinal cyst infection secondary to endobronchial ultrasound-guided transbronchial needle aspiration

“…It may display anechoic (black), hypoechoic (darker), isoechoic (grey), and visible separation in the cyst. The Doppler patterns can be used to differentiate vascular structures [28] . For some cysts with features of solid tumors on CT images due to the presence of proteinaceous content, the fluid-fluid level could be seen on EBUS, which is a more typical feature and can be used to differentiate cysts with features of solid tumors and neoplastic lesions [29] .…”

“…The Doppler patterns can be used to differentiate vascular structures. [28] For some cysts with features of solid tumors on CT images due to the presence of proteinaceous content, the fluid-fluid level could be seen on EBUS, which is a more typical feature and can be used to differentiate cysts with features of solid tumors and neoplastic lesions. [29] The fluid-fluid level of noninfected cyst is probably due to the dependent layering of proteinaceous material within the cyst.…”

A Nomogram to Predict Benign/Malignant Mediastinal Lymph Nodes Based on EBUS Sonographic Features

“…We evaluated ultrasound features according to the following nine categories ( Figure 1 ) [ 12 ]: long-axis (cm), short-axis (>1 cm or <1 cm), long-axis/short-axis ratio (<1.5 or ≥1.5), echogenicity (heterogeneous or homogeneous), margin (distinct or indistinct), blood flow (rich or lacking), fusion (absent or present), CHS (absent or present), and echo intensity (hypoechoic or isoechoic or hyperechoic). Echo intensity was defined as hypoechoic, isoechoic, and hyperechoic contrasted with the surrounding tissue.…”