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Related Experiment Videos

Mediastinoscopic ultrasonography.

Martin Hürtgen1, Michael Wolf, Biruta Witte

  • 1Katholisches Klinikum, Marienhof/St. Josef gGmbH, Brüderhaus, Abt. Thoraxchirurgie, Koblenz, Germany. m.huertgen@kk-koblenz.de

Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
|April 6, 2007
PubMed
Summary
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Mediastinoscopic ultrasound (MUS) accurately predicts tumor resectability in centrally located lung cancer, improving upon computed tomography staging. This new technique aids surgical planning for T4 lung tumors.

Area of Science:

  • Thoracic Surgery
  • Medical Imaging
  • Oncology

Background:

  • Accurate pretherapeutic T4 staging of centrally located lung cancer is vital for treatment planning.
  • Current non-invasive imaging techniques often lack sufficient accuracy for predicting resectability.

Purpose of the Study:

  • To develop and evaluate intraoperative mediastinoscopic ultrasound (MUS) for predicting technical resectability in lung tumors staged as cT4.
  • To assess the accuracy of MUS in determining tumor involvement with mediastinal structures.

Main Methods:

  • A sterilizable fingertip ultrasound probe was guided via video mediastinoscope during staging mediastinoscopy.
  • MUS was performed on 24 patients with cT4 lung tumors; 18 had MUS predictions compared with intraoperative findings.
  • Probe placement minimized air interference by positioning anterior to the tracheobronchial tree and in contact with great vessels.

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Main Results:

  • MUS visualized central vessels and their relationship to tumors with high accuracy, including pulmonary artery and veins.
  • MUS correctly predicted resectability in 18 of 24 patients, all of whom were found to be technically resectable at thoracotomy.
  • T stages determined by MUS correlated accurately with pathologic T stages (pT).

Conclusions:

  • Intraoperative mediastinoscopic ultrasound (MUS) effectively assesses infiltration of great vessels and mediastinum, particularly for right-sided lung tumors.
  • MUS enhances the staging of centrally located lung tumors, complementing endoscopic ultrasound-guided fine needle aspiration for the right upper mediastinum.