Is there any added value of EBUS-TBNA to the identification of non-avid PET-CT lymph nodes?

Abstract

Background: Although the positron emission tomography-computed tomography (PET-CT) is a useful tool for the evaluation of mediastinal and/or hilar lymphadenopathy (MHL), direct tissue sampling is necessary for the confirmation of the findings. Objectives: Our aim was to assess the added value of endobronchial ultrasound guided-transbronchial needle aspiration (EBUS-TBNA) to PET-CT for the diagnosis of MHL. Methods: We retrospectively evaluated all patients who underwent both EBUS-TBNA sampling and PET-CT from February 2016 to August 2017. PET-CT avid MHL and the cytology from EBUS-TBNA samples were analysed. Results: Over the 18-month period, 44 PET-CT were conducted; 146 patients with MHL underwent EBUS-TBNA with 136 of them having adequate lymphoid tissues (93%). The patients who underwent PET-CT and EBUS-TBNA are summarized in the table below. Nine patients, with PET-CT positive but normal cytology on EBUS-TBNA samples, underwent follow up imaging or surgical lymph node biopsy in our hospital, which proved to be true negatives. Conclusions: We observed, albeit our sample numbers, that PET-CT inavid MHL can be reasonably well predictive as being non-pathological when confirmed with EBUS-TBNA sampling.