Endoscopy 2012; 44(06): 618-621
DOI: 10.1055/s-0032-1306774
Innovation Forum
© Georg Thieme Verlag KG Stuttgart · New York

Lymph node characterization in vivo using endoscopic ultrasound spectrum analysis with electronic array echo endoscopes

R. E. Kumon
1   Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
2   Department of Physics, Kettering University, Flint, Michigan, USA
,
A. Repaka
3   Division of Gastroenterology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
4   University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey, USA
,
M. Atkinson
3   Division of Gastroenterology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
,
A. L. Faulx
3   Division of Gastroenterology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
,
R. C. K. Wong
3   Division of Gastroenterology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
,
G. A. Isenberg
3   Division of Gastroenterology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
,
Y.-S. Hsiao
1   Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
,
M. S. R. Gudur
1   Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
,
C. X. Deng
1   Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
,
A. Chak
3   Division of Gastroenterology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
› Author Affiliations
Further Information

Publication History

submitted 01 July 2011

accepted after revision 10 January 2012

Publication Date:
25 May 2012 (online)

Our purpose was to demonstrate the use of radiofrequency spectral analysis to distinguish between benign and malignant lymph nodes with data obtained using electronic array echo endoscopes, as we have done previously using mechanical echo endoscopes. In a prospective study, images were obtained from eight patients with benign-appearing lymph nodes and 11 with malignant lymph nodes, as verified by fine-needle aspiration. Midband fit, slope, intercept, correlation coefficient, and root-mean-square (RMS) deviation from a linear regression of the calibrated power spectra were determined and compared between the groups. Significant differences were observable for mean midband fit, intercept, and RMS deviation (t test P < 0.05). For benign (n = 16) vs. malignant (n = 12) lymph nodes, midband fit and RMS deviation provided classification with 89 % accuracy and area under receiver operating characteristic (ROC) curve of 0.95 based on linear discriminant analysis. We concluded that the mean spectral parameters of the backscattered signals from electronic array echo endoscopy can provide a noninvasive method to quantitatively discriminate between benign and malignant lymph nodes.

 
  • References

  • 1 Catalano MF, Alcocer E, Chak A et al. Evaluation of metastatic celiac axis lymph nodes in patients with esophageal carcinoma: accuracy of EUS. Gastrointest Endosc 1999; 50: 352-356
  • 2 Bhutani MS, Hawes RH, Hoffman BJ. A comparison of the accuracy of echo features during endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration for diagnosis of malignant lymph node invasion. Gastrointest Endosc 1997; 45: 474-479
  • 3 Kumon RE, Olowe K, Faulx AL et al. EUS spectrum analysis for in vivo characterization of pancreatic and lymph node tissue: a pilot study. Gastrointest Endosc 2007; 66: 1096-1106
  • 4 Kumon RE, Pollack MJ, Faulx AL et al. In vivo characterization of pancreatic and lymph node tissue by using EUS spectrum analysis: a validation study. Gastrointest Endosc 2010; 71: 53-63
  • 5 Lizzi FL, Feleppa EJ, Alam SK et al. Ultrasonic spectrum analysis for tissue evaluation. Pattern Recog Lett 2003; 24: 637-658
  • 6 Noritomi T, Machi J, Feleppa EJ et al. In vitro investigation of lymph node metastasis of colorectal cancer using ultrasonic spectral parameters. Ultrasound Med Biol 1998; 24: 235-243
  • 7 Tateishi T, Machi J, Feleppa EJ et al. In vitro investigation of detectability of colorectal lymph nodes and diagnosis of lymph node metastasis in colorectal cancer using B-mode sonography. J Clin Ultrasound 2004; 32: 1-7
  • 8 Mamou J, Coron A, Hata M et al. Three-dimensional high-frequency characterization of cancerous lymph nodes. Ultrasound Med Biol 2010; 36: 361-375
  • 9 Mamou J, Coron A, Oelze ML et al. Three-dimensional high-frequency backscatter and envelope quantification of cancerous human lymph nodes. Ultrasound Med Biol 2011; 37: 345-357
  • 10 Tateishi T, Machi J, Feleppa EJ et al. In vitro diagnosis of axillary lymph node metastases in breast cancer by spectrum analysis of radio frequency echo signals. Ultrasound Med Biol 1998; 24: 1151-1159