Author of

• 20162

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  P1.13 - Radiology/Staging/Screening (ID 699)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Radiology/Staging/Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 22762

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    P1.13-006 - The Value of F-18 FDG PET/CT-guided EBUS-TBNA in Nodal Staging of NSCLC. (ID 8587)

    09:30 - 09:30  |  Author(s): K.H. Jung
    • Abstract
    • Slides

    Background:
    Mediastinal lymph node staging in NSCLC is crucial to set treatment options. But correct nodal staging is also challenging, especially, in regions of endemic for granulomatous diseases. The purpose of the study is to evaluate the value of PET-guided EBUS-TBNA and the efficacy of PET/CT for prediction of cytopathological results of lymph node staging in NSCLC.
    
    Method:
    38 patients who underwent F-18 FDG PET/CT for initial staging of NSCLC and subsequent mediastinal node staging by EBUS-TBNA for clarification of the hilar,mediastinal nodes between Sep.2013 and Jul.2014 were retrospectively reviewed. The clinical nodal staging with PET/CT were correlated with cytopathological results after TBNA. Overall sensitivity, specificity, PPV, NPV,and accuracy were evaluated.
    
    Result:
    From 38 PET scans, total 112 thoracic lymph node stations had noticeable focal hypermetabolisms.82 FDG avid stations were suspected to have metastasis,16 stations were considered as inflammatory nodes,and 14 stations were reported as equivocal findings. The majority of the primary lung pathology which showed equivocal nodal PET findings were adenocarcinoma (9/14). Total 58 thoracic lymph nodes (PET positive 38, PET negative 12, and equivocal PET finding in 8 nodes, respectively) were aspirated in 38 patients. Malignancy was detected in 39 (67.2%) out of 58 lymph nodes. (Figure 1. flow chart)Figure 1 2 patients up-staged from N1 to N2,1 patient up-staged from N2 to N3,and 1 patient down-staged from N3 to N2 after PET-guided EBUS-TBNA. From 8 lymph nodes that showed equivocal PET finding,6 were enlarged and showed heterogenous hypoechogenicity on EBUS.4 node of those were proved to be cytologically metastatic lymph nodes. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of PET-guided EBUS-TBNA on a node-based analysis was 94.9%, 63.2%, 84.1%, 85.8%, and 84.5%, respectively when we combined EBUS findings with PET.
    
    
    
    Conclusion:
    PET-guide EBUS-TBNA offers an effective, accurate, and minimally invasive strategy for evaluating lymph node staging in NSCLC.
    
    

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