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Updated: Sep 28, 2026
Using the Endoscope for Endobronchial Ultrasound in the Esophagus
Published on: November 21, 2023
Computer-assisted analysis of lymph nodes detected by EUS in patients with esophageal carcinoma
David E Loren1, Chandra M Seghal, Gregory G Ginsberg
1University of Pennsylvania School of Medicine, Philadelphia, USA.
Background:
EUS determination of lymph nodal spread of intestinal cancer based on imaging alone is problematic. A noninvasive, reliable means of determining tumor spread to lymph nodes is desirable. This study investigated the feasibility of a computer-assisted evaluation of lymph nodes detected by EUS in patients with esophageal carcinoma.
Methods:
Images were obtained during EUS of esophageal lesions and correlated with histopathologic findings after esophagectomy. Sonographic features of echogenicity, whole-node heterogeneity, and regional variability were assessed by computerized image analysis in patients with benign versus malignant lymphadenopathy.
Results:
Malignant lymph nodes were hypoechoic compared with benign lymph nodes (p < 0.04). Whole lymph node heterogeneity was increased in malignant lymph nodes (p < 0.004). Regional variability was greater for benign lymph nodes.
Conclusions:
These data support the feasibility of a computer-assisted system for analysis of lymph node metastasis in patients with esophageal carcinoma. Further refinements of such a system could increase the accuracy of EUS staging of tumors.