Ultrasound, endoscopic ultrasound elastography, and the strain ratio in differentiating benign from malignant lymph nodes

Okasha, Hussein Hassan; Elkholy, Shaimaa; Sayed, Mohamed; El‐Sherbiny, Mohamed; El-Hussieny, Ramy; El-Gemeie, Emad; Al-Nabawy, Waleed; Mohamed, Moustafa Saeed; Elsherif, Yahia

doi:10.1016/j.ajg.2018.01.001

Cited by 9 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They examined 126 LNs, with a SR cut-off value of 4.6 for malignant LNs. The specificity, sensitivity, NPV, and PPV were 83.3%, 89.8%, 90.2%, and 82.5%, respectively [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…This was comparable to the study done by Paterson et al [ 12 ] that identified a cut-off level of 7.5 that had specificity and PPV of 96% and 95%, respectively, but higher values of sensitivity, NPV, and accuracy of 83%, 86%, and 90%, respectively. Okasha et al [ 11 ] and Larsen et al [ 13 ] identified a lower cut-off value for SR of 4.6 and 4.5 that gave lower values in specificity and PPV of 83.3%, 82.5% and 82%, 67%, respectively.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic Ultrasound Elastography for Evaluation of Lymph Nodes: A Single Center Experience

Altonbary

Hakim

Elshamy

2018

Diagnostic and Therapeutic Endoscopy

View full text Add to dashboard Cite

Background and Aim The differentiation between malignant and benign lymph nodes (LNs) is important for tumor staging, for detection of prognosis, and for selection of the best treatment strategy in many cancers. On B-mode EUS, there are some known criteria that suggest the malignant nature of LNs; these criteria may be found in benign LNs. The aim of the work is to evaluate the effectiveness of elasticity score and SR to differentiate between benign and malignant LNs. Patients and Methods The study was designed as a retrospective study that included 40 patients with abdominal or mediastinal LNs, either associated with primary masses or isolated, referred for EUS evaluation. Elasticity scores and SR were determined during the examination and finally, EUS-FNA was done at the end of the procedure. Results In this 2-years study, 40 patients were enrolled (24 malignant; 16 benign). There were 23 males and 17 females. Their mean age was 52.5 years (range: 28–77). ES alone had a specificity of 87.5%, sensitivity of 41.7%, PPV of 83.3%, NPV of 50%, and accuracy of 60%. Based on the ROC curve analysis results, the best cut-off level of SR to obtain the maximum area under the curve (AUC) was 6.7 with a specificity of 99.9%, sensitivity of 57.1%, PPV of 99.9%, NPV of 64%, and accuracy of 77.5%. Conclusion The use of elasticity score and SR increases the reliability of differentiation between benign and malignant LNs and can decrease the number of unnecessary biopsies.

show abstract

“…They examined 126 LNs, with a SR cut-off value of 4.6 for malignant LNs. The specificity, sensitivity, NPV, and PPV were 83.3%, 89.8%, 90.2%, and 82.5%, respectively [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasound Elastography for Evaluation of Lymph Nodes: A Single Center Experience

Altonbary

Hakim

Elshamy

2018

Diagnostic and Therapeutic Endoscopy

View full text Add to dashboard Cite

show abstract

“…26 In another prospective study comprising 126 patients with lymphadenopathy, the sensitivity and specificity of EUS-guided detection of malignant lymph nodes were 89.8% and 83.3%, respectively. 27 Percutaneous ultrasound-guided portal FNA is currently seldom used because of its invasiveness and a relative high risk of complications. In 2004, Lai et al 29 reported the first case of HCC diagnosis using EUS-FNA of portal vein thrombus, the initial CT scan displayed a thrombosis in the portal vein, intrahepatic biliary dilatation, and a suspicious soft-tissue mass in the pancreatic head.…”

Section: Eus For the Diagnosis Of Metastatic Lymph Nodesmentioning

confidence: 99%

Endoscopic ultrasound for the diagnosis and treatment of primary hepatocellular carcinoma

Wang,

Lu,

Cai

2024

J of Digest Diseases

View full text Add to dashboard Cite

Chronic liver disease has emerged as a significant global concern, with primary hepatocellular carcinoma (HCC) representing a critical consequence of this disease. However, early detection of HCC remains challenging in clinical practice. Recently, there has been a growing interest in applying endoscopic ultrasound (EUS) as a diagnostic tool for gastrointestinal diseases. Nevertheless, using EUS to diagnose and treat HCC is uncommon. In this review we described the diagnostic and therapeutic applications of EUS in primary HCC and evaluated its clinical significance. The diagnostic procedures primarily involve EUS‐guided fine‐needle biopsy or aspiration, assessment of metastatic lymph nodes and portal vein thrombosis, portal pressure monitoring, and portal vein blood collection. Treatment mainly includes EUS‐guided tumor ablation, brachytherapy, injectable chemotherapy, and managing variceal hemorrhage related to portal hypertension.

show abstract

“…When judging malignant LNs with SR, previous research showed that with the cutoff point of SR >2.5, EUS elastography can differentiate benign from atypical malignant mediastinal LN sensitively (56). Okasha et al reported that there were 89.8% sensitivity and 83.3% specificity in differentiating malignant LNs from benign ones with endoscopic UE while using the SR cutoff value >4.61 (55). Altonbary et al found that the sensitivity, specificity, PPV, NPV, and diagnostic accuracy for differentiating benign LNs from malignant LNs were 57.1%, 99.9%, 99.9%, 64%, and 77.5%, respectively, with the mean SR cutoff value >6.7 (53).…”

Section: Differentiation Of Benign and Malignant Lymph Nodesmentioning

confidence: 99%

Ultrasound Elastography for the Evaluation of Lymph Nodes

et al. 2021

View full text Add to dashboard Cite

The differential diagnosis of lymphadenopathy is important for predicting prognosis, staging, and monitoring the treatment, especially for cancer patients. Conventional computed tomography and magnetic resonance imaging characterize lymph node (LN) with disappointing sensitivity and specificity. Conventional ultrasound with the advantage of high resolution has been widely used for the LN evaluation. Ultrasound elastography (UE) using color map or shear wave velocity can non-invasively demonstrate the stiffness and homogeneity of both the cortex and medulla of LNs and can detect early circumscribed malignant infiltration. There is a need of a review to comprehensively discuss the current knowledge of the applications of various UE techniques in the evaluation of LNs. In this review, we discussed the principles of strain elastography and shear wave-based elastography, and their advantages and limitations in the evaluation of LNs. In addition, we comprehensively introduced the applications of various UE techniques in the differential diagnosis of reactive LNs, lymphoma, metastatic LNs, and other lymphadenopathy. Moreover, the applications of endoscopic UE and endobronchial UE are also discussed, including their use for improving the positive rate of diagnosis of fine-needle aspiration biopsy.

show abstract

Ultrasound, endoscopic ultrasound elastography, and the strain ratio in differentiating benign from malignant lymph nodes

Cited by 9 publications

References 27 publications

Endoscopic Ultrasound Elastography for Evaluation of Lymph Nodes: A Single Center Experience

Endoscopic Ultrasound Elastography for Evaluation of Lymph Nodes: A Single Center Experience

Endoscopic ultrasound for the diagnosis and treatment of primary hepatocellular carcinoma

Ultrasound Elastography for the Evaluation of Lymph Nodes

Contact Info

Product

Resources

About