Abstract
In this prospective study endoscopic ultra-sound (EUS) and computed tomography (CC) were evaluated to compare diagnostic accuracy of the two methods. They were performed for nodal staging in selected patients admitted to our institution for non-small-cell lung cancer (NSCLC). from February 1992 to July 1993. 45 patients were recruited for the study When N3 and N2 nodal involvement were excluded on standard chest X-ray. All the patients completed EUS TS and CT exams for staging before treatment. The results of sensitivity, specificity and accuracy were obtained in 30 patients who underwent surgical treatment with macroscopically radical resection of T and N. which allowed a complete surgical and histological comparison of CT and EUS findings. On a her-patient basis CT results were: sensitivity 63.0%. specificity 78.9 % and accuracy of 73.3 on a nodal station basis sensitivity: specificity and accuracy were 70.0%, 85.1% and 81.6% respectively. The EUS evaluation showed, on a per-patient basis, values of sensitivity 45.5%. specificity and overall diagnostic accuracy of 53.3%. On I nodal station basis the results were 50.0%,and 78.2% respectively. The results obtained in the 30 patients when both techniques were taken in association regarding sensitivity (90.9%), sspecificity (73.7%) and accuracy (80.0%) on a per-patient basis suggest that the assocation of EUS and CT offers the best approach for preoperative e staging of NSCL.
Similar content being viewed by others
References
Naruke T, Goya T, Tsuchida R, Suemasu K (1988) The importance of surgery to non-small cell carcinoma of lung with mediastinal lymph node metastasis. Ann Thorac Surg 46: 603
Kirschner PA (1981) Lung cancer: preoperative radiation therapy and surgery. NY State Med J 198: 339
Gralla RJ (1988) Preoperative and adjuvant chemotherapy in non-small cell lung cancer. Semin Oncol 15: 8
Kirsh MM, Sloan H (1982) Mediastinal metastases in bronchogenic carcinoma. Influence of postoperative irradiation, cell type, and location. Ann Thorac Surg 33: 459
Slater JD, Ellerbroch NA, Barkley HT (1981) Radiation therapy following resection of non-small cell bronchogenic carcinoma. Int J Radiat Oncol Biol Phys 20: 945
Yashar J, Weitberg AB, Glicksman AS (1993) Preoperative chemotherapy and radiation therapy for stage III a carcinoma of the lung. Radiology 186: 586
Armstrong JG, Martini N, Kris MG (1992) Induction chemotherapy for non-small cell lung cancer with clinically evident mediastinal node metastases: the role of postoperative radiotherapy. Int J Radiat Oncol Biol Phys 23: 605
ragg DG (1991) Current applications of imaging procedures in the patient with lung cancer. Int J Radiat Oncol Biol Phys 21: 847
Klein JS, Webb WR (1991) The radiologic staging of lung cancer. J Thorac Imaging 7: 29
Poon PY, Bronskill MJ, Henkelmann RM, Rideout DF, Shulman HS, Weisbrod GL, Steinhardt MI, Dunlap HJ, Ginsberg RJ, Feld R, Sutcliffe SB, Williams JI (1987) Mediastinal lymph node metastases from bronchogenic carcinoma: detection with MR imaging and CT. Radiology 162: 651
Kerr KM, Lamb D, Wathen CG (1993) Pathological assessment of mediastinal lymph nodes in lung cancer: implications for non-invasive mediastinal staging. Radiology 187: 586
Kondo D, Imaiwumi M, Toshio A, Naruke T, Suemesu K (1990) Endoscopic ultrasound examination for mediastinal lymph node metastases of lung cancer. Chest 98: 586
Tio TL, Tytgat GNJ (eds) (1986) Atlas of transintestinal ultrasonography. Smith-Klene-French, Rijswijk (The Netherlands)
Tio TL, Tytgat GNJ (1986) Endoscopic ultrasonography in analysing peri-intestinal lymph node abnormality. Scand J Gastroenterol 21: 158–163
Hildebrandt U, Feifel G (1993) Endosonography in the diagnosis of lymph nodes. Endoscopy 25: 243–245
McLoud T, Bourgouin PM, Greenberg RW Kosink JP, Tempeton PA, Shepard JO, Moore EH, Wain JC, Methisen KF, Grillo HC (1992) Bronchogenic carcinoma: analysis of staging in the mediastinum with CT by correlative lymph node mapping and sampling. Radiology 182: 319
Grenier P, Dubray B, Carette MF, Frijia G, Musset D, Chastan GC (1989) Preoperative thoracic staging of lung cancer: CT and RM evaluation. Diagn Intern Radiol 173: 69
Wiersema MJ, Hassig WM, Hawes RH, Wonn MJ (1993) Mediastinal lymph node detection with endosonography. Gastrointest Endosc 39: 788
Ono R (1994) Bronchoscopic ultrasonography. In: Ono R. (ed) Bronchoscopy. Nakayama-Shoten, Tokyo
Heurter T, Hanrath P (1992) Endobronchial sonography: feasibility and preliminary results. Thorax 47: 565–567
Goldberg BB, Steiner RM, Liu JB, Merton DA, Articolo G, Cohn JR, Gottlieb J, McComb BL, Spirn PW (1994) US-assisted bronchoscopy with use of miniature transducer-containing catheters. Radiology 190: 233–237
Ihde DC, Pass HI, Glatstein EJ (1993) Small cell lung cancer. In: DeVita VT, Hellmann S, Rosenberg SA (eds) Cancer: principles and practice of oncology. Lippincott, Philadelphia
Vilmann P, Hancke S, Henriksen FW, Jacobsen GK (1993) Endosonographically guided fine needle aspiration biopsy of malignant lesions in the upper gastrointestinal tract. Endoscopy 25: 523
Wiersema MJ, Kochman ML, Chak A, Cramer HM, Kesler KA (1993) Real-time endoscopic ultrasound-guided fine-needle aspiration of a mediastinal lymph node. Gastrointest Endosc 39 (3): 429–431
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Potepan, P., Meroni, E., Spagnoli, I. et al. Non-small-cell lung cancer: detection of mediastinal lymph node metastases by endoscopic ultrasound and CT. Eur. Radiol. 6, 19–24 (1996). https://doi.org/10.1007/BF00619947
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00619947