1. PET-CT SUV max and Endobronchial Ultrasound Features for Prediction of Malignancy: A Prospective Study.
- Author
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Faria N, Lacerda C, Lopes J, Viana C, and Sucena M
- Subjects
- Humans, Male, Middle Aged, Female, Positron Emission Tomography Computed Tomography, Prospective Studies, Bronchoscopy methods, Neoplasm Staging, Mediastinum pathology, Lymph Nodes diagnostic imaging, Lymph Nodes pathology, Retrospective Studies, Lung Neoplasms diagnostic imaging, Lung Neoplasms pathology
- Abstract
Introduction: Accurate and early staging of lung cancer has a critical impact on its prognosis. EBUS-TBNA is often the procedure of choice for mediastinal staging. Comprehension of the likelihood of malignancy of each lymph node (LN) can assist puncture decision-making during EBUS and offer insight of the procedure expected diagnostic yield., Methods: Prospective analysis of mediastinal LN of patients undergoing EBUS-TBNA from April 2021 to May 2022. The relationship between PET-CT SUV
max levels, EBUS features, and malignancy on LN was investigated. For statistical analysis, patients were assigned to 3 groups: suspected malignancy (diagnosis and/or staging), confirmed malignancy (staging) or suspected benign disease., Results: A total of 363 LN from 132 patients (71% male, mean 62 years old) were analyzed. Among those with suspected benign disease, no LN puncture resulted in a diagnosis of malignancy. PET-CT SUVmax and short axis size were independent factors for malignancy in LN of patients who underwent EBUS for suspected (p < .001 and p = .047, respectively) or confirmed malignancy (p < .001 and p < .001, respectively). All malignant LN presented SUVmax ≥1.85 (≥2.85 for staging EBUS cases) and/or short axis size ≥4.28mm. Vascularized LN were more often malignant in either those with suspected (p = .087) or confirmed (p = .095) malignancy, although not statistically significant. LN that were simultaneously vascularized and lacked central hilar structure were also more commonly malignant (p = .013)., Conclusion: LN that has higher SUVmax and are larger should be prioritized for puncture, followed by those vascularized and lacking central hilar structure. In staging EBUS cases, a systematic sampling (N3-N2-N1) is required and must precede any malignancy yield rationale., (Copyright © 2023 Elsevier Inc. All rights reserved.)- Published
- 2023
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