Integration of Bronchoscopic Transesophageal Ultrasound Examination of the Left Adrenal Gland into Routine Lung Cancer Staging Workup : A Prospective Trial
| Autor: | Hubertus Hautzel, Elena Stenzel, Thomas Hager, Kaid Darwiche, Faustina Funke, R Karpf-Wissel, Stephan Eisenmann, Jonathan Becker, J Winantea |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Adrenal Gland Neoplasms Medizin Adenocarcinoma of Lung Endosonography Metastasis Left adrenal gland 03 medical and health sciences 0302 clinical medicine Bronchoscopy Carcinoma Non-Small-Cell Lung Adrenal Glands medicine Humans 030212 general & internal medicine Endobronchial ultrasound Lung cancer Endoscopic Ultrasound-Guided Fine Needle Aspiration Aged Neoplasm Staging Aged 80 and over medicine.diagnostic_test business.industry Ultrasound Middle Aged medicine.disease Small Cell Lung Carcinoma digestive system diseases Bronchoscopes 030228 respiratory system Prospective trial Carcinoma Squamous Cell Female Esophagoscopy Radiology Lung cancer staging business Learning Curve |
| Popis: | Background: Endobronchial ultrasound (EBUS) with transbronchial needle aspiration increases the diagnostic yield of lung cancer staging. The left adrenal gland (LAG) is a common site for lung cancer metastasis. The modality of transesophageal examination with an EBUS bronchoscope (EUS-B) routinely for LAG has not been assessed. Objective: The aim of this study was to prospectively assess if evaluation and tissue sampling of the LAG could routinely be implemented in an EBUS procedure. Methods: Patients referred for EBUS between March and August 2017 had assessment of the LAG via EUS-B. Fine-needle aspiration (FNA) was performed in cases with a suspicious LAG. The detection rate, procedure time, and learning curve of four experienced EBUS-bronchoscopists was assessed, plus the diagnostic accuracy and complication rate of FNA. Results: In total, 313 consecutive patients were included. The overall LAG detection rate was 87.5%. After the initial learning curve, the detection rate for all four bronchoscopists was >93%. The detection rate did not correlate with any patient characteristics. EUS-B-FNA revealed nine LAG metastases, with a sensitivity, specificity, and accuracy of 75%, 100%, and 99%, respectively. The mean EUS-B operation time was 194.4 s, with 594.8 s for FNA. There were no FNA-associated complications. Conclusions: Evaluation of the LAG with EUS-B could routinely be included in an EBUS procedure if necessary. A high detection rate can be achieved after an initial learning period. FNA of the LAG was feasible and safe. EUS-B of the LAG could be integrated into the usual EBUS/EUS-B procedure in lung cancer staging workup. |
| Databáze: | OpenAIRE |
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