Abedini A, Razavi F, Farahani M, Hashemi M, Emami H, Mohammadi F, Kiani A. The utility of elastography during EBUS-TBNA in a population with a high prevalence of anthracosis.
CLINICAL RESPIRATORY JOURNAL 2020;
14:488-494. [PMID:
32034995 DOI:
10.1111/crj.13159]
[Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 12/29/2019] [Accepted: 01/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND
Ultrasound elastography, is a pioneer sonographic modality that is conducted during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in order to increase the accuracy of sampling location. The current study aims to evaluate the usefulness of elastography during EBUS-TBNA in a population with a high prevalence of anthracosis.
METHODS
This prospective single-blinded study was performed on 69 lymph nodes (LNs) of patients with mediastinal lymphadenopathy undergoing EBUS-TBNA and EBUS-elastography from October 2017 to July 2018. The stiffness level of the tissue was translated into a color to demonstrate the hardness of tissue. Blue and total areas of each section were measured to calculate the hardness of each LN.
RESULTS
Sixty-nine LNs were evaluated by elastography. Twenty percent of LNs were malignant. There was a statistical difference between malignant and non-malignant nodes based on color dominancy (P = 0.032). However, with the exclusion of anthracosis nodes from the analysis, the difference was more significant (P < 0.001). Moreover, when the blue dominancy was used as the predictor of malignancy or anthracosis, the results showed a significant correlation (P < 001).
CONCLUSION
The usefulness of elastography in selecting the hardest area of tissue that is appropriate for diagnosing diseases has been proven previously. Since in countries with a high prevalence of anthracosis, blue color achieved using elastography predicts either malignancy or anthracosis so, cases with blue dominancy of LNs in elastography and the white color in the EBUS-TBNA indicate anthracosis-caused calcification should be reconsidered.
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