| Towards a minimally invasive staging strategy in NSCLC: analysis of PET positive mediastinal lesions by EUS-FNA. | |
| | |
MedLine Citation:
|
PMID: 15013583 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
STUDY OBJECTIVE: To asses the value of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in the nodal staging of patients with (suspected) non-small cell lung cancer (NSCLC) and a (18)FDG positron emission tomography (PET) scan suspect for N2/N3 mediastinal lymph node (MLN) metastases. BACKGROUND: Due to the imperfect specificity of positron emission tomography, PET positive MLN should be biopsied in order to confirm or rule out metastasis. Currently, invasive surgical diagnostic techniques such as mediastinoscopy/-tomy are standard procedures to obtain MLN tissue. The minimally invasive technique of EUS-FNA has a high diagnostic accuracy (90-94%) for the analysis of MLN in patients with enlarged MLN on computed tomography of the chest (CT). DESIGN AND PATIENTS: Thirty-six patients with proven n=26 or suspected n=10 non-small cell lung cancer and a PET scan suspect for N2/N3 lymph node metastases underwent EUS-FNA. When EUS-FNA did not confirm metastasis and the PET lesion was within reach of mediastinoscopy, a mediastinoscopy was performed. EUS-FNA negative patients with PET lesions beyond the reach of mediastinoscopy or those with a negative mediastinoscopy were referred for surgical resection of the tumour and MLN sampling or dissection. RESULTS: EUS-FNA confirmed N2/N3 disease in 25 of the 36 patients (69%) and was highly suspicious in one. In the remaining 10 patients, one PET positive and one PET negative N2 metastasis was detected at thoracotomy. The PPV, NPV, sensitivity, specificity and accuracy of EUS-FNA in analysing PET positive MLN were 100%, 80%, 93%, 100% and 94%, respectively. No complications of EUS-FNA were recorded. CONCLUSIONS AND SIGNIFICANCE: EUS-FNA yields minimally invasive confirmation of MLN metastases in 69% of the patients with potential mediastinal involvement at FDG PET. The combination of PET and EUS-FNA might qualify as a minimally invasive staging strategy for NSCLC. |
| | |
Authors:
|
J T Annema; O S Hoekstra; E F Smit; M Veseliç; M I M Versteegh; K F Rabe |
Related Documents
:
|
8688363 - The use of pet-18fdg imaging in the clinical evaluation of head and neck lymphoma. 8624373 - Role of 67ga scintigraphy in localization of lymphoma. 11677883 - Increased incidence of a midline brain anomaly in patients with nonsyndromic clefts of ... |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Lung cancer (Amsterdam, Netherlands) Volume: 44 ISSN: 0169-5002 ISO Abbreviation: Lung Cancer Publication Date: 2004 Apr |
Date Detail:
|
Created Date: 2004-03-11 Completed Date: 2004-06-15 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8800805 Medline TA: Lung Cancer Country: Ireland |
Other Details:
|
Languages: eng Pagination: 53-60 Citation Subset: IM |
Affiliation:
|
Department of Pulmonary Medicine, Leiden University Medical Center, PO Box 9600, Albinusdreef 2, 2300 RC Leiden, The Netherlands. j.t.annema@lumc.nl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Biopsy, Needle Carcinoma, Non-Small-Cell Lung / classification, pathology* Endosonography / methods* Female Fluorodeoxyglucose F18 / diagnostic use Humans Lung Neoplasms / classification, pathology* Male Middle Aged Neoplasm Metastasis / diagnosis Neoplasm Staging / methods* Radiopharmaceuticals / diagnostic use Sensitivity and Specificity Tomography, Emission-Computed / methods* |
| Chemical | |
Reg. No./Substance:
|
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Small lung tumors with the size of 1cm or less in diameter: clinical, radiological, and histopatholo...
Next Document: Lung cancer patients showing pure ground-glass opacity on computed tomography are good candidates fo...