Histogram-Based Quantitative Evaluation of Endobronchial Ultrasonography Images of Peripheral Pulmonary Lesion

Morikawa, Kei; Kurimoto, Noriaki; Inoue, Tatsuya; Mineshita, Masamichi; Miyazawa, Teruomi

doi:10.1159/000368839

Cited by 17 publications

(15 citation statements)

References 10 publications

(11 reference statements)

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“…Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been shown to be an effective tool in the evaluation of malignant and benign enlarged mediastinal and hilar lymph nodes [1,2,3,4] and has become the procedure of choice [5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

Bispectral Index Monitoring Reduces the Dosage of Propofol and Adverse Events in Sedation for Endobronchial Ultrasound

Quesada

Júdez²,

Ubieto³

et al. 2016

Respiration

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Background: Current guidelines recommend monitoring the anesthetic depth of sedation during respiratory endoscopy by using clinical scales despite their subjective nature and the potential change in the level of sedation caused by frequent stimulation. Monitoring by means of the bispectral index (BIS) has shown its utility in reducing the use of drugs and their adverse events in general anesthesia, but evidence in prolonged sedation is insufficient. Objective: Our objective was to evaluate BIS in patients undergoing endobronchial ultrasound (EBUS). Methods: A randomized cohort study of 90 patients with mediastinal lymph node involvement and/or lung or mediastinal lesions for whom EBUS was indicated, comparing the modified observer's assessment of alertness/sedation scale clinical evaluation (n = 45) versus the BIS evaluation (n = 45) of sedation with propofol-remifentanil, was conducted in order to evaluate the clinical parameters, doses used, adverse events, and tolerance of the procedure. Results: We found a shorter waking time and a significantly lower dose of total propofol in the BIS group. Significantly fewer overall adverse events were recorded in the BIS group and included desaturation, hypotension, and bradypnea. Tolerance was better in the BIS group. No significant differences were found in terms of cough, memory of the procedure, or the level of difficulty of EBUS on the part of the pulmonologists. Conclusions: BIS monitoring of sedation in EBUS makes it possible to reduce the dosage of propofol, thereby shortening the waking time and reducing adverse events. This form of monitoring should be taken into consideration in the future for systematic use in prolonged sedation, as in the case of EBUS.

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Section: Introductionmentioning

confidence: 99%

Bispectral Index Monitoring Reduces the Dosage of Propofol and Adverse Events in Sedation for Endobronchial Ultrasound

Quesada

Júdez²,

Ubieto³

et al. 2016

Respiration

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“…Nguyen et al [14] used small ROIs selected by an expert and analysed images for greyscale texture-based measures. Morikawa et al [19] applied a similar methodology but computed greyscale histogram-based measures.…”

Section: Discussionmentioning

confidence: 99%

“…As address by Morikawa et al [19], image pixels within a 3-mm radius of the centre of the RP-EBUS probe are artefact. Equally, image pixels further than a 5-mm radius from the centre of the RP-EBUS probe are prone to noise due to attenuation of the ultrasound signal.…”

Section: Discussionmentioning

confidence: 99%

Radial Endobronchial Ultrasound Greyscale Texture Analysis Using Whole-Lesion Analysis Can Characterise Benign and Malignant Lesions without Region-of-Interest Selection Bias

Badiei¹,

Nguyen²,

Jersmann³

et al. 2018

Respiration

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Background: Radial-probe endobronchial ultrasound (RP-EBUS) is predominantly used clinically for the localisation of peripheral pulmonary lesions prior to biopsy. However, the RP-EBUS image itself contains information that can characterise the aetiology of lesions. Objectives: The aim of this study was to show the utility of RP-EBUS image analysis using unconstrained regions of interest (ROIs) that utilise more image information and eliminate ROI selection bias. Methods: We developed custom software to analyse RP-EBUS images digitally captured during clinical procedures. Unconstrained ROIs were mapped onto lesions. We computed first-order greyscale image statistics of minimum, maximum, mean, standard deviation and range of pixel intensities, and entropy. We also computed second-order greyscale texture features of contrast, correlation, energy and homogeneity. The results of image analysis were compared to gold-standard tissue diagnosis. Features from expert- and non-expert-defined ROIs were also compared. Results: Eighty-five images were analysed (38 benign and 47 malignant). Five greyscale features were significantly different between benign and malignant lesions. Benign lesions had higher mean (p < 0.01) and maximal (p < 0.001) intensity, greater range (p < 0.001) of pixel intensities and greater entropy (p < 0.01). The highest positive predictive values were associated with maximal (87.8%) and range of pixel (83.8%) intensities. There were no significant differences between expert- and non-expert-defined ROIs. Conclusion: RP-EBUS image analysis using unconstrained ROIs eliminates ROI selection bias and can characterise benign and malignant lesions with an accuracy of up to 85%.

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“…The lack of quantitative parameters generates inter‐observer and intra‐observer variability. Previous reports have shown that greyscale texture analysis of the EBUS B‐mode image could distinguish malignant and benign lesions . However, this analysis was conducted by using ultrasound images that are already converted from the original ultrasonic signals and reconstructed by a specific algorithm.…”

Section: Introductionmentioning

confidence: 99%

Transbronchial evaluation of peripheral pulmonary lesions using ultrasonic spectrum analysis in lung cancer patients

et al. 2019

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Background and objective Analysis of the endobronchial ultrasound (EBUS) radiofrequency spectrum has been used for convex‐probe EBUS technology. Quantitative imaging analysis is also warranted for guided bronchoscopy using radial‐probe EBUS (RP‐EBUS) targeting peripheral pulmonary lesions (PPL). This study aimed to determine the feasibility of radiofrequency spectrum analysis for distinguishing malignant and benign PPL during diagnostic bronchoscopy. Methods Raw RP‐EBUS images with radiofrequency data, including backscatter signals, were prospectively recorded. The ultrasonic spectral parameters, such as intercept, midband‐fit and slope within the region of interest, were retrospectively computed by linear regression analysis and compared with the final diagnosis. Results A total of 71 PPL, including 45 malignant and 26 benign lesions, were analysed. Malignant PPL showed a significantly lower intercept (P < 0.0001), lower midband‐fit (P < 0.0001) and higher slope (P = 0.014) than benign PPL. Analyses of the area under the curve of receiver operating characteristic plots demonstrated that the intercept showed the best diagnostic performance among three parameters (0.87, 0.77 and 0.69 for intercept, midband‐fit and slope, respectively). The sensitivity, specificity, accuracy, positive likelihood and negative likelihood were 75.6%, 96.2%, 83.1%, 19.6 and 0.25 for the intercept; 88.9%, 57.7%, 77.5%, 2.1 and 0.19 for the midband‐fit; and 68.9%, 73.1%, 70.4%, 2.6 and 0.43 for the slope. Conclusion Spectrum analysis of EBUS radiofrequency can be used as a novel non‐invasive predictor of malignant or benign PPL. Analysis of the ‘intercept’ of the targeted lesion may provide useful supporting data for real‐time sampling from PPL during diagnostic bronchoscopy.

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Histogram-Based Quantitative Evaluation of Endobronchial Ultrasonography Images of Peripheral Pulmonary Lesion

Cited by 17 publications

References 10 publications

Bispectral Index Monitoring Reduces the Dosage of Propofol and Adverse Events in Sedation for Endobronchial Ultrasound

Bispectral Index Monitoring Reduces the Dosage of Propofol and Adverse Events in Sedation for Endobronchial Ultrasound

Radial Endobronchial Ultrasound Greyscale Texture Analysis Using Whole-Lesion Analysis Can Characterise Benign and Malignant Lesions without Region-of-Interest Selection Bias

Transbronchial evaluation of peripheral pulmonary lesions using ultrasonic spectrum analysis in lung cancer patients

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