Model of Evison et al for Predicting Malignancy in Lymph Nodes Diagnosed as Negative on EBUS-TBNA

Description

Endobronchial ultrasonography (EBUS) with transbronchial needle aspiration (TBNA) can identify metastatic lung cancer in thoracic lymph nodes. Evison et al developed a simple score for identifying a lymph node with metastatic cancer despite a negative EBUS-TBNA study. The authors are from University Hospital of South Manchester and the University of Manchester.

Patient selection: lymph node negative by EBUS-TBNA

Parameters:

(1) echogenicity

(2) SUV (standardized uptake value) on PET scan

(3) lymph SUV% (ratio of SUV for the lymph node versus the primary tumor)

Parameter	Finding	Points
Echogenicity	homogeneous	0
	heterogeneous	2
SUV	<= 4	0
	> 4	1
lymph SUV%	<= 40	0
	41 to 60	1
	> 60	2

total score =

= SUM(points for all 3 parameters)

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the greater the risk of malignancy.

Total Score	Risk of Malignancy
0 or 1	low
2 to 5	high

Additional findings associated with malignancy:

(1) round shape

(2) absence of a central hilar structure

(3) presence of coagulation necrosis

Performance:

• The sensitivity was 92% and specificity 88%.

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Model of Evison et al for Predicting Malignancy in Lymph Nodes Diagnosed as Negative on EBUS-TBNA

Description

Specialty