Endoscopic ultrasonography is considered the most useful diagnostic modality for regional staging
It is still difficult to diagnose lymph node metastasis by endoscopic ultrasonography images only.
Dr Yoshiki Hirooka and colleagues from Japan report the usefulness of contrast-enhanced endoscopic ultrasonography in the evaluation of benign or malignant lymph nodes based on blood flow patterns.
The researchers performed contrast-enhanced endoscopic ultrasonography in 46 patients with a lymph node in the mediastinum or abdominal cavity.
The subjects consisted of 22 patients with benign lymph nodes and 24 patients with malignant lymph nodes.
The research team conducted both a retrospective and prospective study.
The lesions were examined by endoscopic ultrasonography, and the maximal and minimal diameters of lymph nodes were measured.
| Sensitivity rate of contrast-enhanced-endoscopic ultrasonography was 100%|
|American Journal of Gastroenterology|
Thereafter, the shape and internal echoes were investigated, and the findings were morphologically classified based on Catalano's report.
Enhancement effects and the diagnostic capability of contrast-enhanced- endoscopic ultrasonography were evaluated.
Benign lymph nodes were differentiated from malignant lymph nodes using the enhancement patterns on contrast-enhanced-endoscopic ultrasonography.
The researchers observed that in the retrospective study, there were no significant differences in the maximal diameter of malignant and benign lymph nodes.
The team also noted no differences in the maximal/minimal diameter ratio between malignant and benign lymph nodes.
The morphology was classified into 4 types.
Based on the morphological classification, the sensitivity, specificity, and accuracy rate were 87%, 76%, and 81%, respectively.
Using contrast-enhanced-endoscopic ultrasonography, the team classified the enhancement pattern into 3 types.
The benign lymph node lesions showed uniform enhancement.
The researchers observed a defect of enhancement in all patients with malignant lymph nodes.
The researchers found that sensitivity, specificity, and accuracy rate of contrast-enhanced-endoscopic ultrasonography were 100%, 85%, and 91%, respectively.
In the prospective study, the sensitivity, specificity, and accuracy rate of contrast-enhanced-endoscopic ultrasonography was 100%, 82%, and 92%, respectively.
Dr Hirooka's team concludes, “Contrast-enhanced-endoscopic ultrasonography is useful for differentiating of benign lymph nodes from malignant lymph nodes.”