Comparison of Mediastinal and Hilar Lymph Node Measurements Between Multidetector Computed Tomography and Endobronchial Ultrasound
Keywords:
Mediastinal Lymph Nodes, EBUS-TBNA, Lymphadenopathy, Lung Cancer StagingAbstract
Background: Precise assessment of mediastinal and hilar lymph nodes is essential for diagnosing and staging thoracic diseases. MDCT and EBUS are routinely employed. However, the correlation between their nodal measurements remains unclear. Objective: To compare lymph node size measurements obtained from coronal-plane MDCT and static EBUS images and determine the strength of agreement between these modalities. Methodology: We performed a cross-sectional study with 210 patients. All underwent MDCT followed by EBUS-TBNA. We recorded short- and long-axis lymph node diameters from both modalities. Histopathology, cytology, and clinical follow-up confirmed diagnoses. Intraclass correlation coefficients (ICC) assessed agreement. Results: Of 210 lymph nodes evaluated, paratracheal stations were most frequent (44.3%), followed by subcarinal (32.9%) and hilar (22.9%). Mean short- and long-axis diameters measured by CT (14.9 ± 6.4 mm and 18.3 ± 8.2 mm, respectively) were greater than those measured by EBUS (13.2 ± 6.2 mm and 17.1 ± 8.0 mm, respectively). Among malignant nodes, CT and EBUS size measurements showed closer alignment compared to benign nodes. Of nodes <10 mm on axial CT, 68.8% were >10 mm on EBUS or coronal CT, and 22% were found to be malignant. Agreement between CT and EBUS measurements was moderate, with ICC values of 0.46 for short-axis and 0.52 for long-axis measurements. Conclusion: MDCT tends to overestimate lymph node size compared to EBUS. A substantial portion of subcentimeter nodes harbored malignancy. This underscores the importance of EBUS assessment. Integrating both techniques improves diagnostic accuracy for mediastinal evaluation.References
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