Diagnosis of peripheral lung cancer with three echoic features via endobronchial ultrasound

Chih Hsi Kuo, Shu Min Lin, Ho Chien Chen, Chu Liang Chou, Chih Ten Yu, Han Pin Kuo

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: Endobronchial ultrasonography (EBUS) is useful in localizing peripheral lung lesions. Previous reports have revealed that several characteristic echoic patterns correlate well with the histopathologic findings of benign and malignant lesions. Therefore, EBUS may be also useful in the differential diagnosis of malignant lesions of the lung. Objective: To assess the feasibility of EBUS in the differential diagnosis between malignant and benign lesions by the following three characteristic echoic features indicating malignancy: continuous margin; absence of a linear-discrete air bronchogram; and heterogeneous echogenicity. Method: EBUS images from 224 patients who undergone bronchoscopy for a peripheral lung lesion were analyzed. The sensitivity and specificity for each echoic feature or in combination in diagnosing malignancy or benignity were determined. Result: Continuous margin, absence of linear-discrete air bronchogram, and heterogeneous echogenicity are three echoic features indicating malignancy. The absence of linear-discrete air bronchogram has the highest sensitivity in the diagnosis of malignancy (91.9%), but the lowest specificity (62.4%). By contrast, a well-defined margin has the highest specificity (93.1%), but the lowest sensitivity (27.6%). The sensitivity and specificity for heterogeneous echogenicity are intermediate (65.0% and 90.1%, respectively). The negative predictive value for the malignancy of a lesion with none of these three echoic features is 93.7%. The positive predictive value for malignancy of a lesion with any two of the three echoic features is 89.2%. Conclusion: These results indicate that EBUS is useful as an adjunct in lung cancer diagnosis, especially when peripheral lung lesions are not visible in traditional bronchoscopy.

Original languageEnglish
Pages (from-to)922-929
Number of pages8
JournalChest
Volume132
Issue number3
DOIs
Publication statusPublished - Jan 1 2007
Externally publishedYes

Fingerprint

Lung Neoplasms
Ultrasonography
Neoplasms
Lung
Air
Bronchoscopy
Differential Diagnosis
Sensitivity and Specificity

Keywords

  • Air bronchogram
  • Continuous margin
  • Endobronchial ultrasonography
  • Heterogeneous
  • Lung cancer

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Diagnosis of peripheral lung cancer with three echoic features via endobronchial ultrasound. / Kuo, Chih Hsi; Lin, Shu Min; Chen, Ho Chien; Chou, Chu Liang; Yu, Chih Ten; Kuo, Han Pin.

In: Chest, Vol. 132, No. 3, 01.01.2007, p. 922-929.

Research output: Contribution to journalArticle

Kuo, Chih Hsi ; Lin, Shu Min ; Chen, Ho Chien ; Chou, Chu Liang ; Yu, Chih Ten ; Kuo, Han Pin. / Diagnosis of peripheral lung cancer with three echoic features via endobronchial ultrasound. In: Chest. 2007 ; Vol. 132, No. 3. pp. 922-929.
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abstract = "Background: Endobronchial ultrasonography (EBUS) is useful in localizing peripheral lung lesions. Previous reports have revealed that several characteristic echoic patterns correlate well with the histopathologic findings of benign and malignant lesions. Therefore, EBUS may be also useful in the differential diagnosis of malignant lesions of the lung. Objective: To assess the feasibility of EBUS in the differential diagnosis between malignant and benign lesions by the following three characteristic echoic features indicating malignancy: continuous margin; absence of a linear-discrete air bronchogram; and heterogeneous echogenicity. Method: EBUS images from 224 patients who undergone bronchoscopy for a peripheral lung lesion were analyzed. The sensitivity and specificity for each echoic feature or in combination in diagnosing malignancy or benignity were determined. Result: Continuous margin, absence of linear-discrete air bronchogram, and heterogeneous echogenicity are three echoic features indicating malignancy. The absence of linear-discrete air bronchogram has the highest sensitivity in the diagnosis of malignancy (91.9{\%}), but the lowest specificity (62.4{\%}). By contrast, a well-defined margin has the highest specificity (93.1{\%}), but the lowest sensitivity (27.6{\%}). The sensitivity and specificity for heterogeneous echogenicity are intermediate (65.0{\%} and 90.1{\%}, respectively). The negative predictive value for the malignancy of a lesion with none of these three echoic features is 93.7{\%}. The positive predictive value for malignancy of a lesion with any two of the three echoic features is 89.2{\%}. Conclusion: These results indicate that EBUS is useful as an adjunct in lung cancer diagnosis, especially when peripheral lung lesions are not visible in traditional bronchoscopy.",
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N2 - Background: Endobronchial ultrasonography (EBUS) is useful in localizing peripheral lung lesions. Previous reports have revealed that several characteristic echoic patterns correlate well with the histopathologic findings of benign and malignant lesions. Therefore, EBUS may be also useful in the differential diagnosis of malignant lesions of the lung. Objective: To assess the feasibility of EBUS in the differential diagnosis between malignant and benign lesions by the following three characteristic echoic features indicating malignancy: continuous margin; absence of a linear-discrete air bronchogram; and heterogeneous echogenicity. Method: EBUS images from 224 patients who undergone bronchoscopy for a peripheral lung lesion were analyzed. The sensitivity and specificity for each echoic feature or in combination in diagnosing malignancy or benignity were determined. Result: Continuous margin, absence of linear-discrete air bronchogram, and heterogeneous echogenicity are three echoic features indicating malignancy. The absence of linear-discrete air bronchogram has the highest sensitivity in the diagnosis of malignancy (91.9%), but the lowest specificity (62.4%). By contrast, a well-defined margin has the highest specificity (93.1%), but the lowest sensitivity (27.6%). The sensitivity and specificity for heterogeneous echogenicity are intermediate (65.0% and 90.1%, respectively). The negative predictive value for the malignancy of a lesion with none of these three echoic features is 93.7%. The positive predictive value for malignancy of a lesion with any two of the three echoic features is 89.2%. Conclusion: These results indicate that EBUS is useful as an adjunct in lung cancer diagnosis, especially when peripheral lung lesions are not visible in traditional bronchoscopy.

AB - Background: Endobronchial ultrasonography (EBUS) is useful in localizing peripheral lung lesions. Previous reports have revealed that several characteristic echoic patterns correlate well with the histopathologic findings of benign and malignant lesions. Therefore, EBUS may be also useful in the differential diagnosis of malignant lesions of the lung. Objective: To assess the feasibility of EBUS in the differential diagnosis between malignant and benign lesions by the following three characteristic echoic features indicating malignancy: continuous margin; absence of a linear-discrete air bronchogram; and heterogeneous echogenicity. Method: EBUS images from 224 patients who undergone bronchoscopy for a peripheral lung lesion were analyzed. The sensitivity and specificity for each echoic feature or in combination in diagnosing malignancy or benignity were determined. Result: Continuous margin, absence of linear-discrete air bronchogram, and heterogeneous echogenicity are three echoic features indicating malignancy. The absence of linear-discrete air bronchogram has the highest sensitivity in the diagnosis of malignancy (91.9%), but the lowest specificity (62.4%). By contrast, a well-defined margin has the highest specificity (93.1%), but the lowest sensitivity (27.6%). The sensitivity and specificity for heterogeneous echogenicity are intermediate (65.0% and 90.1%, respectively). The negative predictive value for the malignancy of a lesion with none of these three echoic features is 93.7%. The positive predictive value for malignancy of a lesion with any two of the three echoic features is 89.2%. Conclusion: These results indicate that EBUS is useful as an adjunct in lung cancer diagnosis, especially when peripheral lung lesions are not visible in traditional bronchoscopy.

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