The utility of multi-detector CT in detection and characterization of mesenteric lymphadenopathy with histopathological confirmation

Gawad, Enas Ahmed Abdel; Samra, Manal F. Abu; Talat, Aliaa Mohammed

doi:10.1016/j.ejrnm.2016.06.020

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…Computed tomography (CT) and magnetic resonance imaging (MRI) are routinely obtained as part of the initial staging of CCA and can readily identify overt advanced disease or distant metastasis. These modalities may also identify regional lymphadenopathy and can provide information regarding likelihood for malignant involvement, using characteristics such as size, morphology, and anatomical location . Unfortunately, with accuracy ranging from 24% to 84% for CT and estimated to be 66% for MRI, neither CT nor MRI alone can be relied upon to definitively assess for regional lymphadenopathy .…”

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confidence: 99%

Endoscopic Ultrasound/Fine Needle Aspiration Is Effective for Lymph Node Staging in Patients With Cholangiocarcinoma

et al. 2020

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Background and Aims Presence of malignant regional lymph nodes (MRLNs) precludes curative oncological resection or liver transplantation for cholangiocarcinoma (CCA). Limited data support the utility of endoscopic ultrasound (EUS)/fine needle aspiration (FNA) for detection of MRLNs in extrahepatic CCA, but there are no data for its role in intrahepatic CCA (iCCA). The aim of this study is to evaluate the staging impact of EUS for CCA, including analysis by subtype. Approach and Results We identified consecutive patients with CCA who underwent EUS staging at a single tertiary care center from October 2014 to April 2018. Among this cohort, we abstracted clinical demographic, radiographical, procedural, cytopathological, and surgical data. STATA 15 software was used for comparative analysis calculations (StataCorp LP, College Station, TX). The study cohort included 157 patients; 24 (15%), 124 (79%), and 9 (6%) with intrahepatic, perihilar, and distal CCA, respectively. EUS was able to identify regional lymph nodes (RLNs) in a higher percentage of patients compared to cross‐sectional imaging (86% vs. 47%; P < 0.001). FNA was performed in 133 (98.5%) patients with RLNs, with a median of three passes per node. EUS‐FNA identified MRLN in 27 of 31 (87.1%) patients ultimately found to have MRLNs. For iCCA, EUS detected a higher percentage of RLN compared to cross‐sectional imaging (83% vs. 50%; P = 0.048), with MRLNs identified in 4 (17%) patients. Among the entire cohort, identification of at least one MRLN by EUS was associated with lower median survival (353 vs. 1,050 days; P < 0.001) and increased risk of death (hazard ratio = 4.1; P < 0.001). Conclusions EUS‐FNA is effective for identifying MRLN in patients with CCA, and should be routinely incorporated into staging of all CCA subtypes given the impact of MRLN on prognosis and management decisions.

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confidence: 99%

Endoscopic Ultrasound/Fine Needle Aspiration Is Effective for Lymph Node Staging in Patients With Cholangiocarcinoma

et al. 2020

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“…Vayner et al [9] conducted a prospective study to evaluate the prevalence of enlarged mesenteric lymph nodes in 189 children with mesenteric lymphadenitis and showed that most of the lymph nodes had minimum diameter of >4 mm. Abdel Gawad et al [10] showed that mesenteric lymph nodes with a mean least diameter of 19 mm (range, 4.7 mm to 9 cm) were commonly found in children with mesenteric lymphadenitis. Compared with normal mesenteric lymph nodes, with a mean value of 2.96 mm, mesenteric lymph nodes in children with mesenteric lymphadenitis were significantly larger than normal mesenteric lymph nodes (p=0.02) [10].…”

Section: Discussionmentioning

confidence: 99%

“…Abdel Gawad et al [10] showed that mesenteric lymph nodes with a mean least diameter of 19 mm (range, 4.7 mm to 9 cm) were commonly found in children with mesenteric lymphadenitis. Compared with normal mesenteric lymph nodes, with a mean value of 2.96 mm, mesenteric lymph nodes in children with mesenteric lymphadenitis were significantly larger than normal mesenteric lymph nodes (p=0.02) [10].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Mesenteric Lymph Nodes in a Pediatric Population with Mesenteric Lymphadenitis Using Superb Microvascular Imaging

Feng

Zhang

et al. 2019

Med Sci Monit

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Background This study aimed to evaluate superb microvascular imaging (SMI) as an adjunctive imaging method to evaluate mesenteric lymph nodes in children with mesenteric lymphadenitis compared with healthy children. Material/Methods A retrospective study compared children with mesenteric lymphadenitis (n=27) and healthy children (n=30). Lymph node size was determined using grayscale ultrasonography and parameters of lymph node vascularity were compared using color Doppler flow imaging (CDFI) and SMI. The diagnostic performance of ultrasound (US), US combined with SMI, and US combined with CDFI were compared. Results Lymph nodes from children with mesenteric lymphadenitis (n=77) and normal lymph nodes (n=84) were evaluated by SMI, which showed that the least diameter of lymph nodes in cases of mesenteric lymphadenitis was 0.58±0.15 mm and of normal mesenteric lymph nodes was 0.47±0.08 mm (p<0.001). SMI identified 92.6% of abnormal mesenteric lymph nodes while CDFI detected 85.2%. US combined with SMI had the highest sensitivity (81.5%), and specificity (78.9%) compared with US alone (sensitivity, 63.0%; specificity, 64.9%), and compared with US combined with CDFI (sensitivity, 74.1%; specificity, 75.4%). US combined with SMI and US combined with CDFI achieved the same specificity (76.7%), which was higher than that of US alone (66.7%). Conclusions SMI was superior to color Doppler flow imaging in evaluating the microvasculature in lymphadenopathy in mesenteric lymphadenitis. SMI may be used as an adjunct to grayscale ultrasonography to assist in identifying mesenteric lymphadenopathy in pediatric patients.

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“…In addition, CT cannot distinguish between tumor and fibrotic tissue induced by anticancer treatment. Multidetector-row CT, that was introduced in the late 1990s, can image thinner slices of tissue rapidly, allowing the detection of lymph nodes <5 mm in size, while also minimizing breathing artifacts [28]. Currently, multidetector-row CT scanners with at least four sections are used for staging of malignant lymphoma in patients after injection of iodinated contrast medium.…”

Section: Clinical Imaging Of Lymphoma: Historical Overview and Currenmentioning

confidence: 99%

Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies

England

Cai

2016

Eur J Nucl Med Mol Imaging

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Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future.

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The utility of multi-detector CT in detection and characterization of mesenteric lymphadenopathy with histopathological confirmation

Cited by 7 publications

References 20 publications

Endoscopic Ultrasound/Fine Needle Aspiration Is Effective for Lymph Node Staging in Patients With Cholangiocarcinoma

Endoscopic Ultrasound/Fine Needle Aspiration Is Effective for Lymph Node Staging in Patients With Cholangiocarcinoma

Evaluation of Mesenteric Lymph Nodes in a Pediatric Population with Mesenteric Lymphadenitis Using Superb Microvascular Imaging

Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies

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