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Peer-reviewedCC BY-NC-NDBMC pulmonary medicine

Underestimated value of Hounsfield unit in differentiating benign and malignant lymph nodes via EBUS-TBNA.

  • Caner Çınar1
  • Zeynep Mercancı2
  • Şehnaz Olgun Yıldızeli2
  • Derya Kocakaya2
  • Emine Bozkurtlar3
  • Sait Karakurt2
  1. 1Department of Pulmonary and Critical Care Medicine, Marmara University, Istanbul, Turkey. [email protected].
  2. 2Department of Pulmonary and Critical Care Medicine, Marmara University, Istanbul, Turkey.
  3. 3Department of Pathology, Marmara University, Istanbul, Turkey.
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Abstract

Introduction

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is vital for diagnosing mediastinal/hilar lymphadenopathy. This study investigated the diagnostic performance of Hounsfield unit (HU) values and PET-CT SUVmax in differentiating malignant from benign lymph nodes.Methods

This retrospective analysis included 168 patients who underwent EBUS-TBNA between 2021 and 2024. Data on demographics, smoking history, HU, PET-CT SUVmax, and EBUS lymph node measurements were collected. Statistical methods included logistic regression and receiver operating characteristic (ROC) analysis to assess diagnostic accuracy.Results

Malignant lymph nodes had significantly lower HU values and larger EBUS dimensions (p < 0.05). The PET‒CT SUVmax did not significantly differ (p = 0.607). ROC analysis revealed that HU had the highest predictive accuracy (AUC = 0.678). Logistic regression identified HU as an independent predictor of malignancy.Conclusion

CT-based HU measurements have greater diagnostic value than PET-CT SUVmax in predicting malignancy in EBUS-TBNA-biopsied lymph nodes. HU could aid in guiding biopsy decisions and improve diagnostic accuracy.

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Cite

BibTeXRIS
BibTeX
@article{cınar2026underestimated,
  title = {{Underestimated value of Hounsfield unit in differentiating benign and malignant lymph nodes via EBUS-TBNA.}},
  author = {Caner Çınar and Zeynep Mercancı and Şehnaz Olgun Yıldızeli and Derya Kocakaya and Emine Bozkurtlar and Sait Karakurt},
  journal = {BMC pulmonary medicine},
  year = {2026},
  month = aug,
  doi = {10.1186/s12890-026-04557-9},
  url = {https://europepmc.org/article/MED/42968115},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Underestimated value of Hounsfield unit in differentiating benign and malignant lymph nodes via EBUS-TBNA.
AU  - Caner Çınar
AU  - Zeynep Mercancı
AU  - Şehnaz Olgun Yıldızeli
AU  - Derya Kocakaya
AU  - Emine Bozkurtlar
AU  - Sait Karakurt
PY  - 2026
DA  - 2026/08/05
JO  - BMC pulmonary medicine
DO  - 10.1186/s12890-026-04557-9
UR  - https://europepmc.org/article/MED/42968115
AB  - Introduction  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is vital for diagnosing mediastinal/hilar lymphadenopathy. This study investigated the diagnostic performance of Hounsfield unit (HU) values and PET-CT SUVmax in differentiating malignant from benign lymph nodes.Methods  This retrospective analysis included 168 patients who underwent EBUS-TBNA between 2021 and 2024. Data on demographics, smoking history, HU, PET-CT SUVmax, and EBUS lymph node measurements were collected. Statistical methods included logistic regression and receiver operating characteristic (ROC) analysis to assess diagnostic accuracy.Results  Malignant lymph nodes had significantly lower HU values and larger EBUS dimensions (p < 0.05). The PET‒CT SUVmax did not significantly differ (p = 0.607). ROC analysis revealed that HU had the highest predictive accuracy (AUC = 0.678). Logistic regression identified HU as an independent predictor of malignancy.Conclusion  CT-based HU measurements have greater diagnostic value than PET-CT SUVmax in predicting malignancy in EBUS-TBNA-biopsied lymph nodes. HU could aid in guiding biopsy decisions and improve diagnostic accuracy.
SN  - 1471-2466
ER  -