Assessment of Tissue Adequacy by EBUS in Conjunction with PET Scan and Operator’s Experience
Mediastinal lymph node assessment is a crucial step in non-small cell lung cancer staging. Positron emission tomography (PET) has been the gold standard for the assessment of mediastinal lymphadenopathy, though it has limited specificity. Endobronchial ultrasound-guided transbronchial needle aspirat...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Clinics and Practice |
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| Online Access: | https://www.mdpi.com/2039-7283/12/6/99 |
| _version_ | 1797460819181568000 |
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| author | Nagla Abdel Karim Asad Ullah Steven Pulliam Ahmed Mostafa Alejandro Aragaki Audrey Eubanks Amit Mahajan Mahmoud Shehata Sadia Benzaquen |
| author_facet | Nagla Abdel Karim Asad Ullah Steven Pulliam Ahmed Mostafa Alejandro Aragaki Audrey Eubanks Amit Mahajan Mahmoud Shehata Sadia Benzaquen |
| author_sort | Nagla Abdel Karim |
| collection | DOAJ |
| description | Mediastinal lymph node assessment is a crucial step in non-small cell lung cancer staging. Positron emission tomography (PET) has been the gold standard for the assessment of mediastinal lymphadenopathy, though it has limited specificity. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is quick, accurate, and a less invasive method for obtaining a diagnostic sample in contrast to mediastinoscopy. We performed a retrospective chart analysis of 171 patients to assess the adequacy of tissue obtained by EBUS for diagnosis and molecular profiling as well as the assessment of staging and lymph node (LN) stations diagnostic yield, in correlation to PET scan and the operator’s level of experience. A significantly increased tissue adequacy was observed based on the operators’ experience, with the highest adequacy noted in trained Interventional Pulmonologist (IP) (100%), followed by >5 years of experience (93.33%), and 88.89% adequacy with <5 years of experience (<i>p</i> = 0.0019). PET-CT scan <sup>18</sup>F-fluorodeoxyglucose (FDG) uptake in levels 1, 2, and 3 LN had a tissue adequacy of 76.67%, 54.64%, and 35.56%, respectively (<i>p</i> = 0.0009). EBUS bronchoscopy method could be used to achieve an accurate diagnosis, with IP-trained operators yielding the best results. There is no correlation with PET scan positivity, indicating that both PET and EBUS are complementary methods needed for staging. |
| first_indexed | 2024-03-09T17:10:28Z |
| format | Article |
| id | doaj.art-93a16e6dd97d47f0aa3dd7f7863e06a2 |
| institution | Directory Open Access Journal |
| issn | 2039-7283 |
| language | English |
| last_indexed | 2024-03-09T17:10:28Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Clinics and Practice |
| spelling | doaj.art-93a16e6dd97d47f0aa3dd7f7863e06a22023-11-24T14:05:15ZengMDPI AGClinics and Practice2039-72832022-11-0112694294910.3390/clinpract12060099Assessment of Tissue Adequacy by EBUS in Conjunction with PET Scan and Operator’s ExperienceNagla Abdel Karim0Asad Ullah1Steven Pulliam2Ahmed Mostafa3Alejandro Aragaki4Audrey Eubanks5Amit Mahajan6Mahmoud Shehata7Sadia Benzaquen8Inova Schar Cancer Institute, University of Virginia, Fairfax, VA 22031, USADepartment of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232, USADepartment of Surgery, University of Tennessee Erlanger School of Medicine, Chattanooga, TN 37403, USADivision Internal Medicine, University of Cincinnati, Cincinnati, OH 45221, USADivision Internal Medicine, University of Cincinnati, Cincinnati, OH 45221, USADepartment of Pathology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USAInova Schar Cancer Institute, University of Virginia, Fairfax, VA 22031, USADivision Internal Medicine, University of Cincinnati, Cincinnati, OH 45221, USADivision Internal Medicine, University of Cincinnati, Cincinnati, OH 45221, USAMediastinal lymph node assessment is a crucial step in non-small cell lung cancer staging. Positron emission tomography (PET) has been the gold standard for the assessment of mediastinal lymphadenopathy, though it has limited specificity. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is quick, accurate, and a less invasive method for obtaining a diagnostic sample in contrast to mediastinoscopy. We performed a retrospective chart analysis of 171 patients to assess the adequacy of tissue obtained by EBUS for diagnosis and molecular profiling as well as the assessment of staging and lymph node (LN) stations diagnostic yield, in correlation to PET scan and the operator’s level of experience. A significantly increased tissue adequacy was observed based on the operators’ experience, with the highest adequacy noted in trained Interventional Pulmonologist (IP) (100%), followed by >5 years of experience (93.33%), and 88.89% adequacy with <5 years of experience (<i>p</i> = 0.0019). PET-CT scan <sup>18</sup>F-fluorodeoxyglucose (FDG) uptake in levels 1, 2, and 3 LN had a tissue adequacy of 76.67%, 54.64%, and 35.56%, respectively (<i>p</i> = 0.0009). EBUS bronchoscopy method could be used to achieve an accurate diagnosis, with IP-trained operators yielding the best results. There is no correlation with PET scan positivity, indicating that both PET and EBUS are complementary methods needed for staging.https://www.mdpi.com/2039-7283/12/6/99lymph nodesnon-small cell lung carcinomalymphadenopathy |
| spellingShingle | Nagla Abdel Karim Asad Ullah Steven Pulliam Ahmed Mostafa Alejandro Aragaki Audrey Eubanks Amit Mahajan Mahmoud Shehata Sadia Benzaquen Assessment of Tissue Adequacy by EBUS in Conjunction with PET Scan and Operator’s Experience Clinics and Practice lymph nodes non-small cell lung carcinoma lymphadenopathy |
| title | Assessment of Tissue Adequacy by EBUS in Conjunction with PET Scan and Operator’s Experience |
| title_full | Assessment of Tissue Adequacy by EBUS in Conjunction with PET Scan and Operator’s Experience |
| title_fullStr | Assessment of Tissue Adequacy by EBUS in Conjunction with PET Scan and Operator’s Experience |
| title_full_unstemmed | Assessment of Tissue Adequacy by EBUS in Conjunction with PET Scan and Operator’s Experience |
| title_short | Assessment of Tissue Adequacy by EBUS in Conjunction with PET Scan and Operator’s Experience |
| title_sort | assessment of tissue adequacy by ebus in conjunction with pet scan and operator s experience |
| topic | lymph nodes non-small cell lung carcinoma lymphadenopathy |
| url | https://www.mdpi.com/2039-7283/12/6/99 |
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