Endobronchial ultrasound elastography

Christoph F Dietrich, Christian Jenssen, Felix J F Herth, Christoph F Dietrich, Christian Jenssen, Felix J F Herth

Abstract

Elastographic techniques have recently become available as advanced diagnostic tools for tissue characterization. Strain elastography is a real-time technique used with transcutaneous ultrasound (US) and endoscopic US. Convincing evidence is available demonstrating a significant value of strain elastography for the discrimination of benign and malignant lymph nodes (LNs). This paper reviews preliminary data demonstrating the feasibility of performing real-time elastography during endobronchial US (EBUS) and a potential application of this technique for selection of LNs for EBUS-guided transbronchial needle aspiration in patients with lung cancer and extrathoracic malignancies.

Figures

Figure 1
Figure 1
Normal lymph node (in between arrows)
Figure 2
Figure 2
Inflammatory lymph node. Unspecific inflammatory mediastinal lymphadenopathy showed by endobronchial ultrasound-elastography (homogeneously green lymph node parenchyma with softer hilum [shown in red])
Figure 3
Figure 3
Inflammatory lymph node in a patient with sarcoidosis (homogeneously green lymph node parenchyma with softer hilum [shown in red]). The low strain ratio (2.81) is indicated as well
Figure 4
Figure 4
Circumscribed metastatic infiltration of a mediastinal lymph node shown by endobronchial ultrasound-elastography (circumscribed blue area within the lymph node marked by asterisk)
Figure 5
Figure 5
Diffuse malignant infiltration by lung cancer of a mediastinal lymph node shown by endobronchial ultrasound-elastography (homogeneously blue lymph node tissue)
Figure 6
Figure 6
Diffuse metastatic infiltration of a mediastinal lymph node shown by endobronchial ultrasound-elastography (homogeneously blue lymph node tissue)

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Source: PubMed

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