Exact staging of patients with non-small-cell lung cancer (NSCLC) is important to improve selection of resectable and curable patients for surgery. Positron emission tomography with integrated computed tomography (PET/CT) and endoscopic ultrasound guided fine needle aspiration biopsy (EBUS-TBNA) are new and promising methods, but indications in lung cancer staging are controversial. No studies have compared the 2 methods. The aim of this study was to assess and compare the diagnostic values of PET/CT and EBUS-TBNA for diagnosing advanced lung cancer in patients, who had both procedures performed.
25 patients considered to be potential candidates for resection of verified or suspected NSCLC underwent PET/CT and EBUS-TBNA. The PET/CT and EBUS-TBNA diagnoses were confirmed either by open thoracotomy/scopy, mediastinoscopy or clinical follow-up. Mediastinal involment of lung cancer was defined as tumour-stage ≥ IIIA(N2), corresponding to N2-N3. Diagnostic values of PET/CT and EBUS-TBNA, with regard to the diagnosis of mediastinal involment of lung cancer, were assessed and compared.
10 patients had a pos PETCT for mediastinal involment while mediastinal involment were found in 5 patients with EBUS TBNA.The sensitivity of PET/CT and EBUS-TBNA were respectively 67%% versus 100% for N2-N3 disease . PET/CT had a specificity of 68%, positive predictive value (PPV) of 40% and a negative predictive value (NPV) of 87%. EBUS-TBNA had a specificity of 100%, PPV of 100%, NPV of 100% for mediastinal involment.
EBUS-TBNA had a sensitivity, NPV and PPV for diagnosing advanced lung cancer, superior to PET/CT.
Mark Krasnik, None.