The role of endobronchial ultrasound elastography in the characterization of mediastinal lymphadenopathy: A single-center, prospective, observational study

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Yılmaz Demirci N., Uğraş Dikmen A., Yurdakul A. S. , Öztürk C.

th European Congress for Bronchology and Interventional Pulmonology – Hybrid Edition, 15 - 17 October 2021

  • Publication Type: Conference Paper / Unpublished
  • Gazi University Affiliated: Yes


Objective: This study aims to investigate the diagnostic role of endobronchial ultrasonography elastography features in predicting malignancy.

Methods: Between January 2017 and March 2020, a total of 385 lymph nodes were biopsied using the endobronchial ultrasonography-guided transbronchial needle aspiration from 224 consecutive patients (158 males, 66 females; mean age 61.2±12.4 years; range, 28 to 85 years) were included. Lymph nodes were scored by elastography according to their colors in three categories before the procedure. The strain ratio was calculated based on the region of interest after three measurements.

Results: Of the 385 lymphnodes, 228 were diagnosed with a malignancy through endobronchial ultrasonography-guided transbronchial needle aspiration biopsy. The mean lymph node score of benign versus malignant lesions was 1.5±0.6 and 2.6±0.6, respectively (p<0.001). There was a positive correlation between the lymph node scores and lymph node diameter, strain ratio, color score, shape, vascularity and fluorodeoxyglucose uptake value (p<0.01). The mean strain ratio for malignant and benign lymph nodes was 41.8±33.6 and 8.9±18.2, respectively (p<0.001). With a cut-off value of ≥6.5 of strain ratio, the sensitivity for malignancy was 88.1% and specificity was 83.7%.

Conclusion: This prospective study showed that Endobronchial ultrasonography elastography is useful in predicting malignancy of the lymph nodes when combined with the strain ratio.