title: Computer-assisted analysis of lymph nodes detected by EUS in patients with esophageal carcinoma.
abstract: 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.
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Loren
authors.forename: Chandra M
authors.initials: CM
authors.lastname: Seghal
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Ginsberg
authors.forename: Michael L
authors.initials: ML
authors.lastname: Kochman
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012372:ROC Curve; D012680:Sensitivity and Specificity