Integration of the left adrenal into EUS-B - a prospective study.

Transesophageal ultrasound with the EBUS-bronchoscope (EUS-B) facilitates together with EBUS the staging of lung cancer. Whether EUS-B is feasible for the left adrenal gland (LAG) has not been prospectively evaluated.We run a prospective study with all patients that received EBUS from march-august 2017: Group A with a suspected or history of malignancy; group B without suspicion of malignancy and thoracic lymph nodes.In group A EUS-B-fine needle aspiration (FNA) was performed, if (PET)-CT or EUS-B were suspicious. 4 bronchoscopists (>500 EBUS-procedures) participated.LAG was proven malignant in the following conditions (reference standard): histology by FNA or surgery, size alteration after antitumour therapy.317 patients were included (group A NSCLC n=179, SCLC n=25, extrathoracic tumor n=13; group B n=96). Identification of the LAG was possible in 274 (87.5%). FNA was performed in 78 patients. Diagnostic yield of 88.5%: metastasis in 9 (11.6%), regular adrenal tissue in 59 (75.6%), myelipoma in 1 (1.3%), non-representative in 9 (11.5%) patients. The reference standard proved 12 malignant LAG. This results in PPV, NPV, sensitivity and specificity of 100%, 99%, 75% and 100% respectively. The blinded radiological assessment resulted in lower PPV, NPV, sensitivity and specificity. After a learning curve of 60 procedures each interventionalist was capable to detect the LAG with a 93% probability. No FNA-related adverse events happened.EUS-B is feasible to locate and character...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research