Radial EBUS versus CT-guided needle biopsy for evaluation of solitary pulmonary nodules

Wei Wang,Like Yu,Chuanzhen Chi,Yuchao Wang,Qian Zhang,Ping Zhan,Chunhua Xu

doi:10.18632/oncotarget.23952

Wei Wang, Like Yu + Show 5 more

Open Access

https://doi.org/10.18632/oncotarget.23952

Copy DOI

Journal: Oncotarget	Publication Date: Jan 4, 2018
Citations: 28	License type: cc-by

Affiliation: Southeast University, Nanjing Chest Hospital

Abstract

ObjectiveThis study is aimed to compare the diagnostic yield, complications and influencing factors between Radial endobroncheal ultrasonography guided bronchoscopy(R-EBUS) and CT-guided needle biopsy (CT-PNB), for evaluation of solitary pulmonary nodules(SPNs).Matrials and Methods160 cases of consecutive patients with SPNs were enrolled and divided into R-EBUS and CT-PNB groups randomly. The diagnostic yield, complications and influencing factors between the two groups were evaluated.ResultsSensitivity of R-EBUS for malignancy was 73.7% (42/57) and for benign, was 43.5% (10/23), overall diagnostic accuracy was 65% (52/80). In CT-PNB group, overall diagnostic accuracy was 85% (68/80), sensitivity for malignancy was 87.9% (51/58), and for benign was 81.0% (17/21), respectively. Both overall diagnostic yield and incidence of complications in CT-PNB group were higher than those in R-EBUS group (P = 0.006, P = 0.002). In R-EBUS group, the factors affecting diagnostic yield were size (P = 0.027), the distance between SPNs and pleura (P = 0.031) and the location of the probe to lesions (P = 0.009). In CT-PNB group, the distance from the lesions to pleura was correlated with the incidence of pneumothorax (P = 0.001) and pulmonary haemorrhage (P = 0.042). The location of SPNs were adjacent to great vessels was another influencing factor for pulmonary haemorrhage (P = 0.042).ConclusionsBoth R-EBUS and CT-PNB are valuable tools for diagnosis. SPNs located in medial 1/2 of lung field, or were adjacent to great vessels may be fit for R-EBUS. Those SPNs located in lateral 1/2 of lung field, near to pleura or with less vessels around may be more suitable for CT-PNB.

Highlights

Single pulmonary nodules (SPNs) is defined as single, isolated lesion of circular or ovoid shape, with the diameter of ≤ 30 mm, which is located within the lung parenchyma, surrounded entirely by gas-containing lung tissue and not accompanied wiht hilar enlargement, pleural effusion or lung atelectasis [1]
In computed tomography guided percutaneous needle biopsy (CT-PNB) group, the distance from the lesions to pleura was correlated with the incidence of pneumothorax (P = 0.001) and pulmonary haemorrhage (P = 0.042)
The location of Solitary pulmonary nodule (SPN) were adjacent to great vessels was another influencing factor for pulmonary haemorrhage (P = 0.042)

Summary

Results

Sensitivity of R-EBUS for malignancy was 73.7% (42/57) and for benign, was 43.5% (10/23), overall diagnostic accuracy was 65% (52/80). In CTPNB group, overall diagnostic accuracy was 85% (68/80), sensitivity for malignancy was 87.9% (51/58), and for benign was 81.0% (17/21), respectively Both overall diagnostic yield and incidence of complications in CT-PNB group were higher than those in R-EBUS group (P = 0.006, P = 0.002). In R-EBUS group, the factors affecting diagnostic yield were size (P = 0.027), the distance between SPNs and pleura (P = 0.031) and the location of the probe to lesions (P = 0.009). In CT-PNB group, the distance from the lesions to pleura was correlated with the incidence of pneumothorax (P = 0.001) and pulmonary haemorrhage (P = 0.042). The location of SPNs were adjacent to great vessels was another influencing factor for pulmonary haemorrhage (P = 0.042)

Conclusions

INTRODUCTION

RESULTS

Methods for diagnosis established

MATERIALS AND METHODS