SCIENTIFIC LETTERS Quantitative endoscopic ultrasound elastography in the nodal staging of esophageal cancer
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چکیده
Endoscopic ultrasound (EUS)-guided fine-needle aspiration biopsy (FNAB) is the gold standard for determining lymph node involvement with diagnostic accuracy > 95%, even though it cannot be carried out passing the needle through the primary tumor or vascular structures, and it can be technically difficult. Four conventional criteria characteristic of malignant lymph nodes (LN) utilizing EUS in mode B are: > 1 cm, rounded, hypoechoic, and sharp margins; however, the sensitivity (Sn) and specificity (Sp) of these criteria in distinguishing malignancy exceed 80% only when all of them are present. Elastography (EG) is applied in real time during EUS (EUS-EG) and it evaluates tissue elasticity and hardness. Clinical research has shown favorable results in the differentiation between benign and malignant tissues. EG utilizes a color map (red-green-blue) in the region of interest (ROI) and can be qualitative and quantitative. The blue areas indicate hard tissue, green and yellow indicate intermediate hardness, and red indicates soft tissue. Qualitative EUS-EG is determined through color patterns and has demonstrated an overall accuracy of 88.1% in detecting LN malignancy. Quantitative EUS-EG utilizes second-generation software, is more objective, and enables stiffness quantification by comparing 2 different tissue zones (A and B) of the ROI. Area A includes the greatest surface area of the tissue being studied and area B is a reference surface of normal adjacent tissue that is in red. The A/B coefficient determines the strain ratio (SR). The reported diagnostic accuracy for determining LN malignancy is 90%.
منابع مشابه
SCIENTIFIC LETTERS Quantitative endoscopic ultrasound elastography in the nodal staging of esophageal cancer
Endoscopic ultrasound (EUS)-guided fine-needle aspiration biopsy (FNAB) is the gold standard for determining lymph node involvement with diagnostic accuracy > 95%, even though it cannot be carried out passing the needle through the primary tumor or vascular structures, and it can be technically difficult. Four conventional criteria characteristic of malignant lymph nodes (LN) utilizing EUS in m...
متن کاملSCIENTIFIC LETTERS Quantitative endoscopic ultrasound elastography in the nodal staging of esophageal cancer
Endoscopic ultrasound (EUS)-guided fine-needle aspiration biopsy (FNAB) is the gold standard for determining lymph node involvement with diagnostic accuracy > 95%, even though it cannot be carried out passing the needle through the primary tumor or vascular structures, and it can be technically difficult. Four conventional criteria characteristic of malignant lymph nodes (LN) utilizing EUS in m...
متن کاملSCIENTIFIC LETTERS Quantitative endoscopic ultrasound elastography in the nodal staging of esophageal cancer
Endoscopic ultrasound (EUS)-guided fine-needle aspiration biopsy (FNAB) is the gold standard for determining lymph node involvement with diagnostic accuracy > 95%, even though it cannot be carried out passing the needle through the primary tumor or vascular structures, and it can be technically difficult. Four conventional criteria characteristic of malignant lymph nodes (LN) utilizing EUS in m...
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تاریخ انتشار 2017