scholarly journals Accuracy and Reproducibility of Endoscopic Ultrasound B-Mode Features for Observer-Based Lymph Nodal Malignancy Prediction

Respiration ◽  
2021 ◽  
pp. 1-9
Author(s):  
Roel L.J. Verhoeven ◽  
Fausto Leoncini ◽  
Jorik Slotman ◽  
Chris de Korte ◽  
Rocco Trisolini ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Endoscopic Ultrasound ◽  
Area Under The Curve ◽  
Objective Measure ◽  
Future Research ◽  
Malignancy Risk ◽  
Nodal Size ◽  
Risk Of Malignancy ◽  
Roc Area

<b><i>Background:</i></b> Endoscopic ultrasound routinely guides lymph node evaluation for the staging of a known or suspected lung cancer. Characteristics seen on B-mode imaging might help the observer decide on the lymph nodes of risk. The influence of nodal size on the predictivity of these characteristics and the agreement with which operators can combine these for malignancy risk prediction is to be determined. <b><i>Objectives:</i></b> We evaluated (1) if prospectively scored individual B-mode ultrasound features predict malignancy when further divided by size and (2) assessed if observers were able to reproducibly agree on still lymph node image malignancy risk. <b><i>Methods:</i></b> Lymph nodes as visualized by EBUS were prospectively scored for B-mode characteristics. Still B-mode images were furthermore collected. After collection, a repeated scoring of a subset of lymph nodes was retrospectively performed (<i>n</i> = 11 observers). <b><i>Results:</i></b> Analysis of 490 lymph nodes revealed the short axis size is an objective measure for stratifying risk of malignancy (ROC area under the curve 0.78). With ≥8-mm size, 210/237 malignant lymph nodes were correctly identified (89% sensitivity, 46% specificity, 61% PPV, and 81% NPV). Secondary addition of B-mode features in &#x3c;8-mm nodes had limited value. Retrospective analysis of intra- and interobserver scoring furthermore revealed significant disagreement. <b><i>Conclusions:</i></b> Lymph nodes of ≥8-mm size and preferably even smaller should be aspirated regardless of other B-mode features. Observer disagreement in scoring both small and large lymph nodes suggests it is infeasible to include subjective features for stratification. Future research should focus on (integrating) other (semi)quantitative values for improving prediction.

scholarly journals Core Biopsy and FNA: A Comparison of Diagnostic Yield in Lymph Nodes of Different Ultrasound Determined Malignant Potential

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 37s-37s
Author(s):  
B. May ◽  
A. Rossiter ◽  
P. Heyworth
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
Lymph Nodes ◽  
Clinical Experience ◽  
Core Biopsy ◽  
Diagnostic Yield ◽  
Sampling Technique ◽  
Malignant Potential ◽  
Low Risk ◽  
Risk Of Malignancy

Background: The tissue diagnosis of lymphoma and metastases is commonly obtained from affected lymph nodes. The lymph nodes chosen for biopsy are often the consequence of their appearance on ultrasound, which determines their risk of malignancy. Two frequently used percutaneous sampling techniques are core biopsy and fine needle aspiration (FNA). While core biopsy obtains a larger tissue sample and provides a degree of architectural information, FNA is considered less invasive and has the advantage of immediate confirmation of adequacy by the attending cytologist. Anecdotally, core biopsy is more commonly used when a lymph node is suspected of harboring neoplasia, however a feature of malignancy is hypercellularity, which theoretically should increase the diagnostic yield of FNA. Aim: The aim of this project was to compare the diagnostic capability of FNA and core biopsy in lymph nodes of different malignant potential, as defined by ultrasound, and determine if the radiologic appearance can guide clinicians in their choice of sampling technique. The project also reviewed the role of clinical experience in both the choice of sampling technique and diagnostic yield. Methods: Retrospective study of percutaneous lymph node biopsies performed at a large tertiary hospital between July 2016 and March 2018. The associated ultrasounds were reviewed and the lymph nodes were classified as high or low risk of malignancy by their sonographic appearance. The end point for analysis was the capacity for FNA or core biopsy to provide a definitive diagnosis. The diagnostic yield was then separately assessed for lymph nodes of high and low malignant potential. The effect of clinical experience on diagnostic yield was also examined, by comparing the outcomes of radiology consultants and radiology trainees. Results: 296 lymph node biopsies were reviewed and statistical analysis was performed using logistic regression analysis. Core biopsy, in comparison with FNA, was used twice as often in lymph nodes of high malignant potential, supporting the aforementioned anecdotal evidence. Core biopsy demonstrated superior diagnostic yield in comparison with FNA, providing a diagnostic sample 45% ( P = 0.313) more often in low-risk lymph nodes and 209% ( P = < 0.05) more often in high-risk lymph nodes. Consultant radiologists used FNA 81% more often than core biopsy in lymph nodes of high malignant potential, while radiology trainees used core biopsy 104% more often than FNA in the same group. In high-risk lymph nodes, trainees were 117% ( P = 0.105) more likely to obtain a diagnostic sample than consultants. Conclusion: Core biopsy is superior to FNA in the tissue sampling of lymph nodes regardless of ultrasound determined risk of malignancy. Biopsies obtained by radiology trainees provided a diagnosis twice as often as those obtained by radiology consultants. This appeared to be the consequence of consultant preference for FNA over core biopsy.

scholarly journals Endoscopic ultrasound in the diagnosis of mediastinal diseases

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhiguo Wang ◽  
Chunmeng Jiang
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Endoscopic Ultrasound ◽  
Mediastinal Lymph Node ◽  
Lymph Node Status ◽  
Mediastinal Lymph Nodes ◽  
Mediastinal Diseases ◽  
Mediastinal Lymphoma ◽  
Tissue Acquisition

AbstractEUS is a useful tool for diagnosis of mediastinal diseases. EUS-FNA plays an important role in staging of lung cancer and in tissue acquisition in patients with mediastinal masses. In this review, the following issues will be addressed: EUS-FNA and EBUS-TBNA, metastatic mediastinal lymph nodes diagnosed by EUS, EUS in assessment of mediastinal lymph node status for staging of lung cancer, mediastinal lymphoma diagnosed by EUS, sarcoidosis and tuberculosis diagnosed by EUS.

Contrast-enhanced endoscopic ultrasound features of tubercular lymphadenopathy

2021 ◽  
pp. 004947552110280
Author(s):  
Surinder S Rana ◽  
Nikhil Bush ◽  
Saurabh Dawra ◽  
Ravi Sharma ◽  
Radhika Srinivasan ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Retrospective Analysis ◽  
Endoscopic Ultrasound ◽  
Great Majority ◽  
Contrast Enhanced ◽  
Heterogeneous Enhancement ◽  
Ultrasound Features

There is lack of data on the contrast-enhanced endoscopic ultrasound features of tubercular lymph node; our retrospective analysis of 37 patients with enlarged mediastinal and abdominal lymph nodes showed heterogeneous enhancement in the great majority (70%).

scholarly journals A Giant Lymph Node—Liver Imposter

2021 ◽  
Vol 12 (02) ◽  
pp. 112-113
Author(s):  
Sagar Dembla ◽  
Shujaath Asif ◽  
Aniruddha P. Singh ◽  
Anuradha Sekaran ◽  
Sundeep Lakhtakia ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Endoscopic Ultrasound ◽  
Abdominal Tuberculosis ◽  
Diagnostic Challenge ◽  
Tubercular Lymphadenitis

AbstractAbdominal tuberculosis has insidious course and is a diagnostic challenge. Tubercular lymphadenitis is associated with constitutional symptoms and multiple enlarged lymph nodes. Isolated giant lymph nodes are rare in tuberculosis and are common in lymphoma or malignancy. Peripancreatic mass on endosonography are commonly lymph node less than 4 cm. Isolated giant nonnecrotizing lymph node can mimic liver architecture on endoscopic ultrasound but lack a biliary connection.

scholarly journals Wound Complications Following Surgery to the Lymph Nodes: A protocol for a systematic review and meta-analysis

2021 ◽  
Author(s):  
Ikemsinachi C. Nzenwa ◽  
Hassan A. Iqbal ◽  
Claire Hardie ◽  
George E Smith ◽  
Paolo L Matteucci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Study Design ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Future Research ◽  
Wound Complications ◽  
Anatomical Location ◽  
True Incidence

AbstractBackgroundMalignancies that spread to the lymph nodes may be identified through surgical biopsy, and treatment of metastatic disease may be through lymph node dissection. These surgeries, however, may be associated with significant adverse outcomes, particularly wound complications, the true incidence of which remains unknown. Multiple studies have reported their individual rates of complications in isolation. The aim of this study will be to systematically evaluate data that presents the incidence of wound complications in patients undergoing these surgeries.MethodsWe have designed and registered a protocol for a systematic review and meta-analysis of studies presenting incidence data. We will search MEDLINE, EMBASE and CENTRAL for relevant articles published before March 30th, 2021. Meta-analysis will be undertaken to synthesise an overall incidence of surgical site infection, wound dehiscence, haematoma and seroma. Subgroup analyses will investigate the effects of anatomical location, primary malignancy and study design on pooled incidence. Risk of bias will be evaluated for each included study using bespoke tools matched to the study design.DiscussionThe results of this study will provide the incidence of wound complications and secondary complications following lymph node surgery. This will directly impact upon the consent process, and may influence the nature of future research studies aimed at reducing post-operative complications.

scholarly journals Size of Metastatic Lymph Nodes

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
L. Uriev ◽  
I. Maslovsky ◽  
F. Barak ◽  
D. Ben-Dor
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Clear Correlation ◽  
Review Of The Literature ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Nodal Size ◽  
The Status ◽  
Well Differentiated ◽  
Positive Lymph Nodes

We present a case and review of the literature of well-differentiated sigmoid adenocarcinoma with numerous metastases into pericolic lymph nodes. All positive lymph nodes were small. The authors concluded that there is no clear correlation between nodal size and the likelihood of metastasis in the lymph node, and the status of small lymph nodes must receive special attention by clinicians and pathologists.

scholarly journals How accurate is frozen section pathology compared to permanent pathology in detecting involved margins and lymph nodes in breast cancer?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zahra Mehdipour Namdar ◽  
Navid Omidifar ◽  
Peyman Arasteh ◽  
Majid Akrami ◽  
Sedigheh Tahmasebi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Frozen Section ◽  
Area Under The Curve ◽  
Sentinel Lymph Nodes ◽  
Lymph Node Status ◽  
Pathology Reports ◽  
Sensitivity Specificity

Abstract Background Frozen section (FS) pathology has multiple limitations, and different institutions report variable experiences with the use of FS for diagnosis of tumor involvement. We aimed to compare the FS accuracy with that of permanent pathology (gold standard) regarding marginal involvement and lymph node status using data from the largest breast cancer registry in Iran. Methods In this retrospective study, women who had both FS and permanent pathology reports were included. The two pathology reports were cross compared with regard to the involvement of tumor margins and sentinel lymph nodes. Results Overall, 2786 patients entered the study. Mean age of patients was 48.96±11.44 years. A total of 1742 margins were analyzed. Accordingly, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FS pathology for detection of involvement of involved margins were 78.49%, 97.63%, 65.1%, and 98.7%, respectively. The accuracy and area under the curve (AUC) for FS pathology were 96.61% and 0.73 (95% CI: 0.64–0.831), respectively. A total of 1702 sentinel lymph node biopsies were assessed. Sensitivity, specificity, PPV, and NPV, of FS pathology for detection of lymph node involvement, were 87.1%, 98%, 95.5%, and 93.3%, respectively. Accuracy and AUC of FS for diagnosis of involved lymph nodes were 94.1% and 0.926 (95% CI: 0.909–0.942), respectively. Conclusion Frozen pathology is a suitable method for identifying involved sentinel lymph nodes in patients with breast cancer, but this method has a less than optimum efficacy for detecting and confirming marginal involvement.

Scanning electron microscopy of freeze-fractured prescapular lymph node of caprine

1984 ◽  
Vol 42 ◽  
pp. 244-245
Author(s):  
O. Faroon ◽  
F. Al-Bagdadi ◽  
T. G. Snider ◽  
C. Titkemeyer
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymphatic System ◽  
Three Dimensional ◽  
Meat Products ◽  
The Body ◽  
Morphological Data ◽  
The World ◽  
Cellular Constituent ◽  
Scanning Electron

The lymphatic system is very important in the immunological activities of the body. Clinicians confirm the diagnosis of infectious diseases by palpating the involved cutaneous lymph node for changes in size, heat, and consistency. Clinical pathologists diagnose systemic diseases through biopsies of superficial lymph nodes. In many parts of the world the goat is considered as an important source of milk and meat products.The lymphatic system has been studied extensively. These studies lack precise information on the natural morphology of the lymph nodes and their vascular and cellular constituent. This is due to using improper technique for such studies. A few studies used the SEM, conducted by cutting the lymph node with a blade. The morphological data collected by this method are artificial and do not reflect the normal three dimensional surface of the examined area of the lymph node. SEM has been used to study the lymph vessels and lymph nodes of different animals. No information on the cutaneous lymph nodes of the goat has ever been collected using the scanning electron microscope.

Body Distribution of Lipiodol 131J Following Intralymphatic Radiotherapy

1965 ◽  
Vol 05 (01) ◽  
pp. 1-11
Author(s):  
G. Fava ◽  
L. Roncoroni
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
General Introduction ◽  
Autopsy Findings ◽  
Body Distribution ◽  
Exact Data ◽  
Radioisotope Therapy

SummaryAn account is given of the principles of lymph node dosimetry in radioisotope therapy with Lipiodol 131J. After a general introduction, exact data on the concentrations reached by the radionuclide in the lymph nodes, liver, spleen, thyroid and blood of patients subjected to this treatment are reported. Finally mention is made of a number of particularly interesting autopsy findings.

Sentinel lymph node diagnostic in prostate carcinoma: Part II: Biokinetics and dosimetry of 99mTc-Nanocolloid after intraprostatic injection

2002 ◽  
Vol 41 (02) ◽  
pp. 102-107 ◽  
Author(s):  
J. Kopp ◽  
H. Vogt ◽  
F. Wawroschek ◽  
S. Gröber ◽  
R. Dorn ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Lymph Node ◽  
Urinary Bladder ◽  
Lymph Nodes ◽  
Effective Dose ◽  
Residual Activity ◽  
Tracer Uptake ◽  
Lymphatic Transport ◽  
Radionuclide Distribution ◽  
Radioactivity Uptake

Summary Aim: To visualise the sentinel lymph nodes (SLNs) of the prostate we injected the radiotracer into the parenchyma of the prostate. The activity was deposited in liver, spleen, bone marrow, urinary bladder and regional lymphatic system. The aim of this work is to determine biokinetical data and to estimate radiation doses to the patient. Methods: The patients with prostate cancer received a sonographically controlled, transrectal administration of 99mTc-Nanocoll®, injected directly into both prostate lobes. In 10 randomly selected patients radionuclide distribution and its time course was determined via regions of interest (ROIs) over prostate, urinary bladder, liver, spleen and the lymph nodes. The uptake in the SLNs was estimated from gamma probe measurements at the surgically removed nodes. To compare tumour positive with tumour free lymph nodes according to SLN-uptake and SLNlocalisation we evaluated 108 lymph nodes out of 24 patients with tumour positive SLN. For calculating the effective dose according to ICRP 60 of the patients we used the MIRD-method and the Mirdose 3.1 software. Results: The average uptake of separate organs was: bladder content 24%, liver 25.5%, spleen 2%, sum of SLN 0.5%. An average of 9% of the applied activity remained in the prostate. The residual activity was mainly accumulated in bone marrow and blood. Occasionally a weak activity enrichment in intestinal tract and kidneys could be recognized. The effective dose to the patient was estimated to 7.6 μSv/MBq. The radioactivity uptake of the SLN varied in several orders of magnitude between 0.006% and 0.6%. The probability of SLN-metastasis was found to be independent from tracer uptake in the lymph node. The radioactivity uptake of the SLNs in distinct lymph node regions showed no significant differences. Conclusion: The radiotracer is transferred out of the prostate via blood flow, by direct transfer via the urethra into the bladder and by lymphatic transport. Injecting a total activity of 200 MBq leads to a mean effective dose of 1.5 mSv. It is not recommended to use the tracer uptake in lymph nodes as the only criterion to characterize SLNs.

Sign in / Sign up

Export Citation Format

Share Document