Priority of PET-CT vs CT Thorax for EBUS-TBNA 22G vs 19G: Mesothorax Lymphadenopathy

Lung lesions and undiagnosed mesothorax lymphadenopathy is an issue that several doctors face in the everyday clinical practice. PET-CT and CT of the thorax are usually the first examinations to identify characteristics of the lesions before biopsy. We performed a retrospective study with 450 patien...

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Bibliographic Details
Published in:Journal of Cancer 2021-01, Vol.12 (19), p.5874-5878
Main Authors: Zarogoulidis, Paul, Huang, Haidong, Hu, Zhenli, Wu, Ning, Wang, Jiannan, Petridis, Dimitris, Tsakiridis, Kosmas, Matthaios, Dimitris, Kosmidis, Christoforos, Hohenforst-Schmidt, Wolfgang, Tolis, Christos, Boukovinas, Ioannis, Courcoutsakis, Nikolaos, Nikolaidis, George, Sardeli, Chrysanthi, Bai, Chong, Karapantzou, Chrysanthi
Format: Article
Language:English
Subjects:
Algorithms
Biopsy
Confidence intervals
Cost analysis
Disease
Hospitals
Investigations
Lung cancer
Metabolism
Research Paper
Sarcoidosis
Thorax
Tomography
Ultrasonic imaging
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Summary:Lung lesions and undiagnosed mesothorax lymphadenopathy is an issue that several doctors face in the everyday clinical practice. PET-CT and CT of the thorax are usually the first examinations to identify characteristics of the lesions before biopsy. We performed a retrospective study with 450 patients that had EBUS-TBNA with 22G, Upgraded 22G and 19G needles with and without PET-CT in order to identify the cost effeteness of performing EBUS-TBNA before or after PET-CT. All centers used the same PET-CT equipment and EBUS-TBNA system. Three types of needle were used for the endoscopy in order to identify similarities and differences for the cost-effectiveness. The costs in every center for every examination and materials were the same. There were more block slices for 19G>22Gupgraded>21G>22G and there was cost-effectiveness when in general PET-CT was performed prior to biopsy of any lesion. 19G needle was more effective for lymphomas, while 22Gupgraded and 21G needles were more cost-effective when used for smaller lesions for primary lung cancer of metastatic disease. We have been using PET-CT and EBUS-TBNA in the everyday clinical practice according to the current guidelines for initial disease staging and re-staging. However; we can also use both in a cost effective method based on the initial radiologic findings.
ISSN:1837-9664
1837-9664
DOI:10.7150/jca.59892