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Bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer

OBJECTIVES: To explore the diagnostic accuracy of ultrasound measurement of optic nerve sheath diameter (ONSD) and optic disc height (ODH) in detecting intracranial hypertension in non‐small‐cell lung cancer (NSCLC) patients with leptomeningeal metastases (LM). METHODS: Seventy‐two patients with NSC...

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Autores principales: Jiang, Cheng, Lin, Yongjuan, Li, Huiying, Xie, Yu, Yu, Tingting, Feng, Jingyu, Huang, Mingmin, Guo, Aibin, Shen, Haiyun, Zhang, YiDan, Yin, Zhenyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067128/
https://www.ncbi.nlm.nih.gov/pubmed/36464859
http://dx.doi.org/10.1002/cam4.5484
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author Jiang, Cheng
Lin, Yongjuan
Li, Huiying
Xie, Yu
Yu, Tingting
Feng, Jingyu
Huang, Mingmin
Guo, Aibin
Shen, Haiyun
Zhang, YiDan
Yin, Zhenyu
author_facet Jiang, Cheng
Lin, Yongjuan
Li, Huiying
Xie, Yu
Yu, Tingting
Feng, Jingyu
Huang, Mingmin
Guo, Aibin
Shen, Haiyun
Zhang, YiDan
Yin, Zhenyu
author_sort Jiang, Cheng
collection PubMed
description OBJECTIVES: To explore the diagnostic accuracy of ultrasound measurement of optic nerve sheath diameter (ONSD) and optic disc height (ODH) in detecting intracranial hypertension in non‐small‐cell lung cancer (NSCLC) patients with leptomeningeal metastases (LM). METHODS: Seventy‐two patients with NSCLC‐LM and 65 patients with NSCLC were enrolled. The ONSD, ODH, eyeball transverse diameter (ETD), and eyeball vertical diameter (EVD) were measured by ultrasound. Subsequently, lumbar puncture was performed in NSCLC‐LM patients to measure cerebrospinal fluid pressure (CSFP), and intrathecal chemotherapy was regularly implemented. Pearson's correlation analysis was used to analyze the relationship between CSFP and ultrasound findings. The diagnostic accuracy of ONSD, ODH, and combined ONSD and ODH was evaluated by receiver operating characteristic (ROC) curve analysis and the corresponding area under the ROC curve (AUC). RESULTS: The ONSD, ODH, ONSD/ETD, and ONSD/EVD values were higher in the NSCLC‐LM group (all p < 0.05). The ONSD, ODH, ONSD/ETD, and ONSD/EVD values were all elevated in the abnormally elevated CSFP group (all p < 0.05). ONSD, ODH, ONSD/ETD, and ONSD/EVD were positively correlated with CSFP (r = 0.531, 0.383, 0.534, and 0.535, all p < 0.0001). The AUCs for ONSD, ODH, ONSD/ETD, and ONSD/EVD to detect CSFP >280 mmH2O were 0.787 (95% CI: 0.64–0.93, sensitivity 68.75%, specificity 91.07%), 0.885 (95% CI: 0.81–0.96, sensitivity 100%, specificity 69.64%), 0.765 (95% CI: 0.64–0.89, sensitivity 81.25%, specificity 64.29%), and 0.788 (95% CI: 0.64–0.93, sensitivity 56.25%, specificity 91.07%), respectively. When ONSD was combined with ODH, the AUC was 0.913 (95% CI: 0.83–0.99, sensitivity 87.85%, specificity 85.70%). Furthermore, intrathecal chemotherapy was associated with a downtrend in CSFP and ultrasound findings. CONCLUSION: There are important advantages of using bedside ultrasonography for detecting elevated CSFP in NSCLC‐LM patients. Further research should be performed to evaluate the clinical significance of an enlarged ONSD and increased ODH in NSCLC‐LM.
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spelling pubmed-100671282023-04-03 Bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer Jiang, Cheng Lin, Yongjuan Li, Huiying Xie, Yu Yu, Tingting Feng, Jingyu Huang, Mingmin Guo, Aibin Shen, Haiyun Zhang, YiDan Yin, Zhenyu Cancer Med RESEARCH ARTICLES OBJECTIVES: To explore the diagnostic accuracy of ultrasound measurement of optic nerve sheath diameter (ONSD) and optic disc height (ODH) in detecting intracranial hypertension in non‐small‐cell lung cancer (NSCLC) patients with leptomeningeal metastases (LM). METHODS: Seventy‐two patients with NSCLC‐LM and 65 patients with NSCLC were enrolled. The ONSD, ODH, eyeball transverse diameter (ETD), and eyeball vertical diameter (EVD) were measured by ultrasound. Subsequently, lumbar puncture was performed in NSCLC‐LM patients to measure cerebrospinal fluid pressure (CSFP), and intrathecal chemotherapy was regularly implemented. Pearson's correlation analysis was used to analyze the relationship between CSFP and ultrasound findings. The diagnostic accuracy of ONSD, ODH, and combined ONSD and ODH was evaluated by receiver operating characteristic (ROC) curve analysis and the corresponding area under the ROC curve (AUC). RESULTS: The ONSD, ODH, ONSD/ETD, and ONSD/EVD values were higher in the NSCLC‐LM group (all p < 0.05). The ONSD, ODH, ONSD/ETD, and ONSD/EVD values were all elevated in the abnormally elevated CSFP group (all p < 0.05). ONSD, ODH, ONSD/ETD, and ONSD/EVD were positively correlated with CSFP (r = 0.531, 0.383, 0.534, and 0.535, all p < 0.0001). The AUCs for ONSD, ODH, ONSD/ETD, and ONSD/EVD to detect CSFP >280 mmH2O were 0.787 (95% CI: 0.64–0.93, sensitivity 68.75%, specificity 91.07%), 0.885 (95% CI: 0.81–0.96, sensitivity 100%, specificity 69.64%), 0.765 (95% CI: 0.64–0.89, sensitivity 81.25%, specificity 64.29%), and 0.788 (95% CI: 0.64–0.93, sensitivity 56.25%, specificity 91.07%), respectively. When ONSD was combined with ODH, the AUC was 0.913 (95% CI: 0.83–0.99, sensitivity 87.85%, specificity 85.70%). Furthermore, intrathecal chemotherapy was associated with a downtrend in CSFP and ultrasound findings. CONCLUSION: There are important advantages of using bedside ultrasonography for detecting elevated CSFP in NSCLC‐LM patients. Further research should be performed to evaluate the clinical significance of an enlarged ONSD and increased ODH in NSCLC‐LM. John Wiley and Sons Inc. 2022-12-04 /pmc/articles/PMC10067128/ /pubmed/36464859 http://dx.doi.org/10.1002/cam4.5484 Text en © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Jiang, Cheng
Lin, Yongjuan
Li, Huiying
Xie, Yu
Yu, Tingting
Feng, Jingyu
Huang, Mingmin
Guo, Aibin
Shen, Haiyun
Zhang, YiDan
Yin, Zhenyu
Bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer
title Bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer
title_full Bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer
title_fullStr Bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer
title_full_unstemmed Bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer
title_short Bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer
title_sort bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067128/
https://www.ncbi.nlm.nih.gov/pubmed/36464859
http://dx.doi.org/10.1002/cam4.5484
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