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Abstract: Poster Presentations |

ASSESSMENT OF POSITRON EMISSION TOMOGRAPHY POSITIVE LYMPH NODES: ULTRASOUND-GUIDED TRANSBRONCHIAL NEEDLE ASPIRATION OR MEDIASTINOSCOPY? FREE TO VIEW

Philippe E. Pierard, MD*; Gavin Plat, MD; Jean Faber, MD; Thierry Prigogine, MD; Vincent Ninane, PhD
Author and Funding Information

CHU Charleroi, Charleroi, Belgium


Chest


Chest. 2005;128(4_MeetingAbstracts):324S. doi:10.1378/chest.128.4_MeetingAbstracts.324S
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Abstract

PURPOSE:  Positron emission tomography with 18-fluorodeoxyglucose (FDG-PET) is more accurate than CT scan for staging of mediastinal and hilar lymph nodes. Nevertheless, histological sampling of positive lymph nodes is required to exclude false positives. The diagnostic/staging yield of endobronchial ultrasound (EBUS) guided transbronchial needle aspiration (TBNA) was assessed in this particular clinical setting. The number of avoided surgical procedures was evaluated.

METHODS:  All consecutive patients referred for staging and/or diagnosis of mediastinal FDG-PET positive lesions were included. Data were prospectively collected. TBNA sampling of lymph nodes was performed after EBUS. In case of negative results, further surgical sampling or follow-up allowed to reach the diagnosis.

RESULTS:  From January 2003 to June 2004, 33 patients were included. The average number of TBNA samples per patient was 4.2 ± 1.5. Sensitivity of EBUS-TBNA for sampling of positive FDG-PET lymph nodes was 93%, negative predictive value 71% and accuracy was 94%.

CONCLUSION:  The present study shows that TBNA combined with EBUS is a very safe and effective method to assess patients with FDG-PET positive lymph nodes. In 25 (76%) of the 33 patients, surgical staging procedures were suppressed.

CLINICAL IMPLICATIONS:  EBUS-TBNA should be considered as a primary method of evaluation of FDG-PET positive lymph nodes and may replace the majority of surgical mediastinal staging/diagnostic procedures.

DISCLOSURE:  Philippe Pierard, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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