Non small cell lung cancer ultrasound: Difference between revisions

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==Overview==
==Overview==


On endobronchial and endoscopic ultrasound, characteristic findings of non-small cell lung cancer include enlarged lymph nodes and local invasion to adjacent [[bronchial]] structures and [[mediastinum]]. Endobronchial ultrasound is a first-line diagnostic modality for [[mediastinal]] staging.
On [[Endoscopic ultrasound|endobronchial ultrasound (EBUS)]] and [[endoscopic ultrasound]], characteristic findings of non-small cell lung cancer include [[Lymphadenopathy|enlarged lymph nodes]] and local invasion to adjacent [[bronchial]] structures and [[Mediastinal mass|mediastinum]]. [[Endoscopic ultrasound|Endobronchial ultrasound]] is a first-line diagnostic modality for [[Mediastinal mass|mediastinal staging]].


==Ultrasound==
==Ultrasound==
Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref><ref name="cancer">Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016</ref>  
Endobronchial ultrasound is a first-line diagnostic modality for [[Mediastinal tumor|mediastinal staging]].<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref><ref name="cancer">Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016</ref>
**Endobronchial and endoscopic esophageal ultrasound are mainly used to identify mediastinal metastasis.
* [[Endoscopic ultrasound|Endobronchial]] and [[Endoscopic ultrasound|endoscopic esophageal ultrasound]] are mainly used to identify [[Mediastinal tumor|mediastinal metastasis]].
** On ultrasound (endobronchial/endoscopic esophageal ultrasound), characteristic findings of non-small cell lung cancer include:
* On [[Endoscopic ultrasound|ultrasound (endobronchial/endoscopic esophageal ultrasound)]], characteristic findings of non-small cell lung cancer include:
*** Enlarged lymph nodes
** [[Lymphadenopathy|Enlarged lymph nodes]]
*** Local invasion of adjacent [[bronchial]] structures and [[mediastinum]]
** Local invasion of adjacent [[bronchial]] structures and [[Mediastinal tumor|mediastinum]]
** Indications for the endobronchial ultrasound:
* Indications for the [[Endoscopic ultrasound|endobronchial ultrasound]]:
***Evaluation of lymph nodes and other structures in the [[mediastinum]]  
**Evaluation of [[Mediastinal lymph node|lymph nodes]] and other structures in the [[mediastinum]]  
***Mediastinal invasion staging  
**[[Mediastinal tumor|Mediastinal invasion staging]]
***Determination of management strategy
**Plan for management  
***Real-time evaluation of structures
**Real-time evaluation of structures
 
 
The table below summarizes the advantages and disadvantages of both ultrasound modalities, for the diagnostic assessment of non-small cell lung cancer.  
* The table below summarizes the advantages and disadvantages of both ultrasound modalities, for the diagnostic assessment of non-small cell lung cancer.  


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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |  Endobronchial ultrasound (EBUS)
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |  [[Endoscopic ultrasound|Endobronchial ultrasound (EBUS)]]
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*Direct visualization of lymph node stations.  
*Direct visualization of [[Lymph node|lymph node stations]].  
*Complements endoscopic ultrasound: covers lymph node stations 2R and 4R which are difficult to access by endoscopic ultrasound
*Complements endoscopic ultrasound: covers lymph node stations 2R and 4R which are difficult to access by endoscopic ultrasound
*Lower false-negative rate than with blind transbronchial fine needle aspiration and fewer complications
*Lower false-negative rate than with blind [[Needle aspiration biopsy|transbronchial fine needle aspiration]] and fewer complications
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*More invasive than endoscopic ultrasound, few practitioners, but rapidly growing in popularity
*More invasive than endoscopic ultrasound, few practitioners, but rapidly growing in popularity
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*Least invasive modality
*Least invasive modality
*Uses the esophagus to access mediastinal lymph nodes
*Uses the [[esophagus]] to access [[Mediastinal lymph node|mediastinal lymph nodes]]
*Excellent for staging lymph nodes
*Excellent for staging [[lymph node metastases]]
*Useful for station 2L and 4L, L adrenal, celiac lymph node
*Useful for station 2L and 4L, L adrenal, [[Celiac lymph nodes|celiac lymph node]]
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*Cannot reliably access right sided paratracheal lymph node stations 2 R and 4R
*Cannot reliably access right sided [[Paratracheal lymph nodes|paratracheal lymph node]] stations 2R and 4R
*Accurate discrimination of primary hilar tumors and involved lymph nodes is important
*Accurate discrimination of primary hilar tumors and involved lymph nodes is important
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Latest revision as of 19:26, 9 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

On endobronchial ultrasound (EBUS) and endoscopic ultrasound, characteristic findings of non-small cell lung cancer include enlarged lymph nodes and local invasion to adjacent bronchial structures and mediastinum. Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.

Ultrasound

Endobronchial ultrasound is a first-line diagnostic modality for mediastinal staging.[1][2]

The table below summarizes the advantages and disadvantages of both ultrasound modalities, for the diagnostic assessment of non-small cell lung cancer.

Procedure Advantages Disadvantages
Endobronchial ultrasound (EBUS)
  • More invasive than endoscopic ultrasound, few practitioners, but rapidly growing in popularity
Endoscopic ultrasound (EUS)
  • Cannot reliably access right sided paratracheal lymph node stations 2R and 4R
  • Accurate discrimination of primary hilar tumors and involved lymph nodes is important

References

  1. ↑ Kinsey CM, Arenberg DA (2014). "Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging". Am. J. Respir. Crit. Care Med. 189 (6): 640–9. doi:10.1164/rccm.201311-2007CI. PMID 24484269.
  2. ↑ Tests for non-small cell lung cancer. American Cancer Society. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-diagnosis Accessed on February 25, 2016


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