PURPOSE: To evaluate the outcomes of sampling GGO lesions using advanced bonchoscopic tools as Electromagnetic Navigation Bronchoscope (ENB) and Radial Endobronchial Ultrasound Probe (REBUS) and to assess the metabolic activity of GGO lesions by Positron Emission Tomography (PET).
METHODS: This case series is part of Electromagnetic Navigation Bronchoscope registry. It included 13 patients with GGO lesions detected during CT screening of high risk patients for malignancy. They were evaluated by PET as a part of diagnostic workup of malignancy; PET activity was assessed by measuring maximum Standardized Uptake Value (SUV) at lesion site. The histopathology samples were obtained by using combined ENB and REBUS.
RESULTS: The demographic characteristics of these patients were M: F ratio= 7:6 and mean age of 73±7. The mean lesion size was 22.9± 7.8, the ratio of pure to mixed GGO was 9:4.The histopathology sampling using combined ENB and REBUS was conclusive in 8 cases, two cases were true negative for malignancy, and failure was in 3 cases which were diagnosed surgically.Among the eight patients successfully diagnosed by ENB, 5 patients were adenocarcinoma with BAC component, one case was diagnosed with Herpes Simplex and another case diagnosed as Mycobacterium Fortuitum.The diagnoses of the failure cases were as follows: Adenocarcinoma, B cell lymphoma and Carcinoid tumour.PET evaluation of GGO lesions showed a low mean SUV value of 2.04±2.07 despite 8 cases proven to be malignant.
CONCLUSION: The localized GGO with low FDG-PET uptake could be malignant rather than benign lesion.
CLINICAL IMPLICATIONS: ENB and REBUS can serve as surrogate to surgery in sampling GGO lesions and establishing the diagnosis.
DISCLOSURE: Rania Abdallah, Consultant fee, speaker bureau, advisory committee, etc. Dr. Gildea receives fees of $5,000 or more per year as a paid consultant or speaker for the Superdimension companny.; No Product/Research Disclosure Information