Cancer Management and Research (Aug 2024)

The Effect of Hounsfield Unit Value on the Differentiation of Malignant/Benign Mediastinal Lymphadenopathy and Masses Diagnosed by Endobronchial Ultrasonography

  • Gegin S,
  • Pazarlı AC,
  • Özdemir B,
  • Özdemir L,
  • Aksu EA

Journal volume & issue
Vol. Volume 16
pp. 1013 – 1020

Abstract

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Savaş Gegin,1 Ahmet Cemal Pazarlı,2 Burcu Özdemir,1 Levent Özdemir,1 Esra Arslan Aksu3 1Samsun Training and Research Hospital, Pulmonology Clinic, Samsun, Türkiye; 2Tokat Gaziosmanpaşa University, Faculty of Medicine, Department of Pulmonary Diseases, Tokat, Türkiye; 3Samsun University Faculty of Medicine, Pulmonology Department, Samsun, TürkiyeCorrespondence: Ahmet Cemal Pazarlı, Tokat Gaziosmanpaşa University, Faculty of Medicine, Department of Pulmonary Diseases, Tokat, Türkiye, Tel +90 5053696860, Fax +03562129500, Email [email protected]: In cases where standardized maximum uptake (SUVmax) values in positron emission tomography (PET-CT) were not sufficient to differentiate mediastinal lymphadenopathy and masses from malignant or benign, the contribution of Hounsfield unit (HU) values in thorax computed tomography to the diagnosis was evaluated.Material Method: The study was conducted by evaluating the data of 182 patients between 2019 and 2023. HU values on non-contrast thorax computed tomography and PET-CT SUVmax values of biopsied masses and lymph nodes were compared with histopathological diagnoses.Results: Patients, 58 females (31.9%) and 124 males (68.1%), who underwent EBUS were included in the study. Biopsies were taken from 233 stations (199 lymph nodes, 34 masses) from 182 patients. A total of 135 of the biopsies taken from 233 stations were histopathologically malignant and 98 were benign. While PET-CT SUVmax values of cases with benign histopathology were 4.5 ± 3.5, it was 7.6 ± 4.2 in patients with malignant pathology (p 0.05). When HU was compared according to lung cancer type, it was found to be significantly higher in non-small cell lung cancer (p=0.035). A weak (r=0.182) positive and significant relationship (p< 0.01) was found between PET-CT values and HU values in thorax computed tomography.Conclusion: While positron emission tomography maintains its importance in the differentiation of mediastinal lymphadenopathy and masses from malignant to non-malignant, it was concluded that HU values in computed tomography are not sufficient to distinguish malignant/non-malignant.Keywords: Hounsfield unit, positron emission tomography, SUVmax, benign, malignant, mediastinal lymphadenopathy

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