Usefulness of contrast-enhanced endoscopic ultrasonography in the differentiation between malignant and benign lymphadenopathy

Akira Kanamori, Yoshiki Hirooka, Akihiro Itoh, Senju Hashimoto, Hiroki Kawashima, Kazuo Hara, Hiroki Uchida, Jun Goto, Naoki Omiya, Yasumasa Niwa, Hidemi Goto

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) is considered the most useful diagnostic modality for regional staging; however, it is still difficult to diagnose lymph node metastasis by EUS images only. In this study, we report the usefulness of contrast-enhanced EUS (CE-EUS) in the evaluation of benign lymph nodes (BLN) or malignant lymph nodes (MLN) based on blood flow patterns. SUBJECTS AND METHODS: In the retrospective study, CE-EUS was performed in 46 patients in whom EUS revealed lymph node in the mediastinum or abdominal cavity. The subjects consisted of 22 patients with BLN and 24 patients with MLN. The lesions were examined by EUS, and the maximal and minimal diameters of lymph nodes were measured. 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 CE-EUS were evaluated. In the prospective study, BLNs were differentiated from MLN using the enhancement patterns on CE-EUS based on the results of the retrospective study, and the diagnostic capability was evaluated. RESULTS: In the retrospective study, there were no significant differences in the maximal diameter and maximal/minimal diameter ratio between MLN and BLN. The morphology was classified into four types. Based on the morphological classification, the sensitivity, specificity, and accuracy rate were 88.2%, 77.3%, and 82.1%, respectively. On CE-EUS, the enhancement pattern was classified into three types. The BLN lesions showed uniform enhancement (19/22). In all patients with MLN, a defect of enhancement was observed (24/24). The sensitivity, specificity, and accuracy rate of CE-EUS were 100%, 86.4%, and 92.3%, respectively. In the prospective study, the sensitivity, specificity, and accuracy rate of CE-EUS were 100%, 81.8%, and 92.0%, respectively. CONCLUSIONS: CE-EUS is useful for differentiating BLN from MLN.

Original languageEnglish
Pages (from-to)45-51
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume101
Issue number1
DOIs
Publication statusPublished - 01-01-2006
Externally publishedYes

Fingerprint

Endosonography
Lymph Nodes
Retrospective Studies
Lymphadenopathy
Sensitivity and Specificity
Prospective Studies
Abdominal Cavity
Mediastinum

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Kanamori, Akira ; Hirooka, Yoshiki ; Itoh, Akihiro ; Hashimoto, Senju ; Kawashima, Hiroki ; Hara, Kazuo ; Uchida, Hiroki ; Goto, Jun ; Omiya, Naoki ; Niwa, Yasumasa ; Goto, Hidemi. / Usefulness of contrast-enhanced endoscopic ultrasonography in the differentiation between malignant and benign lymphadenopathy. In: American Journal of Gastroenterology. 2006 ; Vol. 101, No. 1. pp. 45-51.
@article{1b77f676ee124fc38e3b448d9196c77d,
title = "Usefulness of contrast-enhanced endoscopic ultrasonography in the differentiation between malignant and benign lymphadenopathy",
abstract = "BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) is considered the most useful diagnostic modality for regional staging; however, it is still difficult to diagnose lymph node metastasis by EUS images only. In this study, we report the usefulness of contrast-enhanced EUS (CE-EUS) in the evaluation of benign lymph nodes (BLN) or malignant lymph nodes (MLN) based on blood flow patterns. SUBJECTS AND METHODS: In the retrospective study, CE-EUS was performed in 46 patients in whom EUS revealed lymph node in the mediastinum or abdominal cavity. The subjects consisted of 22 patients with BLN and 24 patients with MLN. The lesions were examined by EUS, and the maximal and minimal diameters of lymph nodes were measured. 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 CE-EUS were evaluated. In the prospective study, BLNs were differentiated from MLN using the enhancement patterns on CE-EUS based on the results of the retrospective study, and the diagnostic capability was evaluated. RESULTS: In the retrospective study, there were no significant differences in the maximal diameter and maximal/minimal diameter ratio between MLN and BLN. The morphology was classified into four types. Based on the morphological classification, the sensitivity, specificity, and accuracy rate were 88.2{\%}, 77.3{\%}, and 82.1{\%}, respectively. On CE-EUS, the enhancement pattern was classified into three types. The BLN lesions showed uniform enhancement (19/22). In all patients with MLN, a defect of enhancement was observed (24/24). The sensitivity, specificity, and accuracy rate of CE-EUS were 100{\%}, 86.4{\%}, and 92.3{\%}, respectively. In the prospective study, the sensitivity, specificity, and accuracy rate of CE-EUS were 100{\%}, 81.8{\%}, and 92.0{\%}, respectively. CONCLUSIONS: CE-EUS is useful for differentiating BLN from MLN.",
author = "Akira Kanamori and Yoshiki Hirooka and Akihiro Itoh and Senju Hashimoto and Hiroki Kawashima and Kazuo Hara and Hiroki Uchida and Jun Goto and Naoki Omiya and Yasumasa Niwa and Hidemi Goto",
year = "2006",
month = "1",
day = "1",
doi = "10.1111/j.1572-0241.2006.00394.x",
language = "English",
volume = "101",
pages = "45--51",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "1",

}

Kanamori, A, Hirooka, Y, Itoh, A, Hashimoto, S, Kawashima, H, Hara, K, Uchida, H, Goto, J, Omiya, N, Niwa, Y & Goto, H 2006, 'Usefulness of contrast-enhanced endoscopic ultrasonography in the differentiation between malignant and benign lymphadenopathy', American Journal of Gastroenterology, vol. 101, no. 1, pp. 45-51. https://doi.org/10.1111/j.1572-0241.2006.00394.x

Usefulness of contrast-enhanced endoscopic ultrasonography in the differentiation between malignant and benign lymphadenopathy. / Kanamori, Akira; Hirooka, Yoshiki; Itoh, Akihiro; Hashimoto, Senju; Kawashima, Hiroki; Hara, Kazuo; Uchida, Hiroki; Goto, Jun; Omiya, Naoki; Niwa, Yasumasa; Goto, Hidemi.

In: American Journal of Gastroenterology, Vol. 101, No. 1, 01.01.2006, p. 45-51.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Usefulness of contrast-enhanced endoscopic ultrasonography in the differentiation between malignant and benign lymphadenopathy

AU - Kanamori, Akira

AU - Hirooka, Yoshiki

AU - Itoh, Akihiro

AU - Hashimoto, Senju

AU - Kawashima, Hiroki

AU - Hara, Kazuo

AU - Uchida, Hiroki

AU - Goto, Jun

AU - Omiya, Naoki

AU - Niwa, Yasumasa

AU - Goto, Hidemi

PY - 2006/1/1

Y1 - 2006/1/1

N2 - BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) is considered the most useful diagnostic modality for regional staging; however, it is still difficult to diagnose lymph node metastasis by EUS images only. In this study, we report the usefulness of contrast-enhanced EUS (CE-EUS) in the evaluation of benign lymph nodes (BLN) or malignant lymph nodes (MLN) based on blood flow patterns. SUBJECTS AND METHODS: In the retrospective study, CE-EUS was performed in 46 patients in whom EUS revealed lymph node in the mediastinum or abdominal cavity. The subjects consisted of 22 patients with BLN and 24 patients with MLN. The lesions were examined by EUS, and the maximal and minimal diameters of lymph nodes were measured. 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 CE-EUS were evaluated. In the prospective study, BLNs were differentiated from MLN using the enhancement patterns on CE-EUS based on the results of the retrospective study, and the diagnostic capability was evaluated. RESULTS: In the retrospective study, there were no significant differences in the maximal diameter and maximal/minimal diameter ratio between MLN and BLN. The morphology was classified into four types. Based on the morphological classification, the sensitivity, specificity, and accuracy rate were 88.2%, 77.3%, and 82.1%, respectively. On CE-EUS, the enhancement pattern was classified into three types. The BLN lesions showed uniform enhancement (19/22). In all patients with MLN, a defect of enhancement was observed (24/24). The sensitivity, specificity, and accuracy rate of CE-EUS were 100%, 86.4%, and 92.3%, respectively. In the prospective study, the sensitivity, specificity, and accuracy rate of CE-EUS were 100%, 81.8%, and 92.0%, respectively. CONCLUSIONS: CE-EUS is useful for differentiating BLN from MLN.

AB - BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) is considered the most useful diagnostic modality for regional staging; however, it is still difficult to diagnose lymph node metastasis by EUS images only. In this study, we report the usefulness of contrast-enhanced EUS (CE-EUS) in the evaluation of benign lymph nodes (BLN) or malignant lymph nodes (MLN) based on blood flow patterns. SUBJECTS AND METHODS: In the retrospective study, CE-EUS was performed in 46 patients in whom EUS revealed lymph node in the mediastinum or abdominal cavity. The subjects consisted of 22 patients with BLN and 24 patients with MLN. The lesions were examined by EUS, and the maximal and minimal diameters of lymph nodes were measured. 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 CE-EUS were evaluated. In the prospective study, BLNs were differentiated from MLN using the enhancement patterns on CE-EUS based on the results of the retrospective study, and the diagnostic capability was evaluated. RESULTS: In the retrospective study, there were no significant differences in the maximal diameter and maximal/minimal diameter ratio between MLN and BLN. The morphology was classified into four types. Based on the morphological classification, the sensitivity, specificity, and accuracy rate were 88.2%, 77.3%, and 82.1%, respectively. On CE-EUS, the enhancement pattern was classified into three types. The BLN lesions showed uniform enhancement (19/22). In all patients with MLN, a defect of enhancement was observed (24/24). The sensitivity, specificity, and accuracy rate of CE-EUS were 100%, 86.4%, and 92.3%, respectively. In the prospective study, the sensitivity, specificity, and accuracy rate of CE-EUS were 100%, 81.8%, and 92.0%, respectively. CONCLUSIONS: CE-EUS is useful for differentiating BLN from MLN.

UR - http://www.scopus.com/inward/record.url?scp=33644755810&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644755810&partnerID=8YFLogxK

U2 - 10.1111/j.1572-0241.2006.00394.x

DO - 10.1111/j.1572-0241.2006.00394.x

M3 - Article

VL - 101

SP - 45

EP - 51

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 1

ER -