PREDICTED MALIGNANCY OF PULMONARY LESION BY USING TUMOR INSPECTOR VERSION 1 PROGRAM IN PHRAMONGKUTKLAO HOSPITAL

Abstract

Background:Bronchoscopy for diagnosis had been performed for decade for tissue diagnosis. Pulmonary nodule can be originated from any caused, ranging from benign granuloma and infectious process to malignancy. Establishing the etiology of pulmonary nodule in accurate manner assumes critical importance, since surgical resection in a patient with early-stage lung cancer provides the highest chance of cure. By the same token, avoiding thoracic surgery for benign SPN whenever possible does obviate significant morbidity. At present Endobronchial ultrasound have been performed more often. The characteristic of endobronchial ultrasound with guide sheath can be predicted which pulmonary nodule could be benign or malignant in picture. There will be vary in interpreted outcome due to depending on pulmonologist’s experienced. We developed a tumor inspector program V.1 for helping to interpreted characteristic of endobronchial ultrasound picture which make it more stable, faster to interpreted and used for further treatment planning. Objective: To evaluate accuracy in interpretation characteristic endobronchial ultrasound picture of tumor inspector program V.1 compared with three pulmonology interventionists agreement. Methods:Cross-sectional study including patients who had pulmonary nodule that undergo EBUS-GS and obtained pathological tissue diagnosis. Results:Two hundred and eight patients were included in this study, mean age 61 years old were studied. One hundred and twenty-six (60.58%) were male. Thirty-four (16.35%) patients had history of smoking. Thirty-four patients (16.35%) had previous malignancy. In study we used pathological report as a gold standard. There were sensitivity 90.6% ,specificity 22.5% ,PPV 65.2%, NPV 60% and accuracy 64.42% in humans interpretation that compatible with pathological report. And there were sensitivity 90.0%%, specificity 81.2%, PPV 88.5% ,NPV 84.4% and accuracy 87.0% in version 1 tumor inspector program. Conclusions:In patients with pulmonary nodule, tumor inspector V.1 program had significantly higher specificity and accuracy to predict malignancy possibility than three pulmonology interventionists agreement.gram.