Author of

• 13580

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  P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Biology, Pathology, and Molecular Testing
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 13596

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    P1.04-016 - Assessment of the Adequacy of Tissue Diagnosis by EBUS in Relation to the PET Scan and the Operator's Experience (ID 3101)

    09:30 - 09:30  |  Author(s): M. Mahmoud
    • Abstract

    Background:
    Lung cancer remains the leading cause of cancer related death in USA and around the world. Multiple modalities are available for sampling lung neoplasms, mediastinal and hilar lymph nodes . Endobronchial ultrasound –guided transbronchial needle aspiration (EBUS-TBNA) has become an important diagnostic tool . Although the samples obtained by EBUS-TBNA are smaller than specimens collected by other surgical methods, the procedure has shown excellent specificity and sensitivity for the diagnosis of neoplastic diseases, is cost-effective compared to mediastinoscopy , and has become the procedure of choice for initial evaluation of patients with mediastinal and hilar lymphadenopathy . EBUS is currently performed by both interventional and general pulmonologists. Aim of the study: To assess the adequacy of tissue for diagnosis in relevance to PET scan, the diagnostic yield of the various lymph node (LN) stations and the level of experience of the operator.
    
    Methods:
    We reviewed the chart of 171 patients who underwent EBUS between the years of 2011-2013. We reviewed the pathological diagnosis, the LN stations, the PET scan results and the operator who performed the EBUS.
    
    Results:
    We included 171 patients where adequacy of tissue diagnosis was achieved by majority of patients in whom EBUS was performed (p<.0001). More tissue seemed to be positive in LN station 4 compared to the other LN stations but with no statistical significance. There was no correlation between the positivity of the PET scan and the tissue adequacy for diagnosis by EBUS (p=0.6410). PET scan showed a trend to increase in positive uptake in LN station 2 (p=0.0705). The adequacy of tissue diagnosis was achieved most significantly by Interventional Pulmonary (IP) trained operator, followed by an operator of more than 5 years’ experience followed by an operator of less than 5 years’ experience with 100% ‚ 93.33% ‚ 88.89% subsequently for tissue diagnosis accuracy (p=0.0019). The diagnostic tissue adequacy had a positive correlation with the PET scan when analyzed by operator, where the operator with more than five years’ experience had a closer correlation with the PET scan positive uptake. The percentage of tissue adequacy in relation to the PET scan positive uptake was of 54.64% ‚ 76.67% and 35.56% subsequently (p=0.0009).
    
    Conclusion:
    The adequacy of tissue diagnosis was achieved by majority of patients in whom EBUS was performed. There was no correlation between the positivity of the PET scan and the tissue adequacy for diagnosis by EBUS therefore PET scan and EBUS should be used complementary to each other for the appropriate diagnosis and staging of patients. The adequacy of tissue diagnosis was achieved most significantly by (IP) trained operator, followed by an operator of more than 5 years’ experience followed by an operator of less than 5 years’ experience.