Endobronchial Ultrasound-guided Transbronchial Needle Aspiration of Hilar and Mediastinal Lymph Nodes Detected on 18F-fluorodeoxyglucose Positron Emission Tomography/computed Tomography

Overview

Journal Jpn J Clin Oncol

Publisher Oxford University Press

Specialty Oncology

Date 2016 Mar 24

PMID 27004902

Citations 1

Authors

Daisuke Minami

Nagio Takigawa

Naohiro Oda

Takashi Ninomiya

Toshio Kubo

Kadoaki Ohashi

Akiko Sato

Katsuyuki Hotta

Masahiro Tabata

Mitsumasa Kaji

Mitsune Tanimoto

Katsuyuki Kiura

Affiliations

Soon will be listed here.

Abstract

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration is of diagnostic value in hilar/mediastinal (N1/N2) lymph node staging. We assessed the utility of endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer patients with N1/N2 lymph nodes detected on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography.

Methods: Fifty lung cancer patients with N1/N2 disease on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography underwent endobronchial ultrasound-guided transbronchial needle aspiration for pathological lymph nodes between November 2012 and April 2015. The diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration, lymph node site and size, number of needle passes and complications were evaluated retrospectively from patients' medical records. Malignancy was defined as a maximum standardized uptake value (SUVmax) >2.5.

Results: The median longest diameter of the 61 lymph nodes (29 subcarinal, 21 right lower paratracheal, 6 left lower paratracheal, 4 right hilar and 1 upper paratracheal) was 23.4 mm (range: 10.4-45.7); the median number of needle passes was 2 (range: 1-5). There were no severe complications. A definitive diagnosis was made by endobronchial ultrasound-guided transbronchial needle aspiration in 39 patients (31 adenocarcinomas, 3 small-cell carcinomas, 2 squamous-cell carcinomas, 3 large-cell neuroendocrine carcinomas). In the remaining 11 patients, the diagnosis was indefinite: insufficient endobronchial ultrasound-guided transbronchial needle aspiration material was collected in two patients and non-specific lymphadenopathy was confirmed by endobronchial ultrasound-guided transbronchial needle aspiration or thoracotomy in the other nine patients. The mean lymph node SUVmax was 7.09 (range: 2.90-26.9) and was significantly higher in true-positive than in false-positive nodes (P < 0.05, t-test). Non-specific lymphadenopathy was diagnosed by expert visual interpretation of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography images in five of the nine patients.

Conclusion: Endobronchial ultrasound-guided transbronchial needle aspiration accurately diagnoses N1/N2 disease detected on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography.

Citing Articles

Evaluation of hypermetabolic mediastinal-hilar lymph nodes determined by PET/CT with EBUS-TBNA and calculation of SUVmax cutoff values in differentiation of malignancy.

Ugurlu E, Metin M, Cetin N, Kilicarslan E, Degirmencioglu S, Sengoz T Medicine (Baltimore). 2023; 102(35):e34928.

PMID: 37657039 PMC: 10476785. DOI: 10.1097/MD.0000000000034928.

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