Evaluating the use of elastography in endobronchial ultrasound technique as a diagnostic approach for mesothorax lymphadenopathy

ABSTRACT

Introduction: Non-small cell lung cancer is still diagnosed at a late stage although we have new diagnostic equipment such the radial endobronchial ultrasound, convex probe endobronchial ultrasound, and electromagnetic navigation. The diagnostic techniques have been upgraded with rapid on-site evaluation (ROSE) and currently from 2014 real-time elastography is being evaluated as a ROSE technique.

Areas covered: A thorough search was performed on PubMed and Scopus with the following key words: elastography, strain ratio, convex probe EBUS, endoscopic ultrasound (EUS), elastography. In the current mini review, we will focus on published data regarding elastography with the convex probe endobronchial ultrasound in two different systems and comment on this future ROSE technique. Elastography, strain ratio, and factors such as(I) margin (indistinct or distinct); (II) shape (oval or round); (III) short-axis size less or more than 1 cm; (IV) presence or absence of central hilar structure (CHS); (V) echogenicity (homogeneous or heterogeneous); and (VI) presence or absence of coagulation necrosis sign are presented in our review based on published literature.

Expert opinion: Current data indicate that we can have up to 93% sensitivity and specificity of real-time elastography and strain ratio for the evaluation of benignancy and malignancy; however, sample biopsy is still necessary. For now, we can only reduce the number of punctures.

KEYWORDS:

• Lung cancer
• NSCLC
• endobronchial ultrasound
• EBUS
• elastography
• strain ratio

Article highlights

• Elastography for optimal biopsy sample

• Elastography for gene identification

• Differences between ultrasound endoscopes

• Biopsy samples with 22G needles

• Sedation during biopsy with endobronchial ultrasound (EBUS)

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This paper was not funded.