Author of

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  P1.05 - Interventional Diagnostics/Pulmonology (Not CME Accredited Session) (ID 937)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

  • 26476

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    P1.05-03 - Significance of Lymph Node SUVmax In Predicting Nodal Metastasis By EBUS in Lung Cancer Patients (ID 12043)

    16:45 - 18:00  |  Author(s): Caitlin Anstee
    • Abstract
    • Slides

    Background
    

    Nodal staging of non-small-cell lung cancer (NSCLC) patients begins with imaging such as Positron emission tomography–computed tomography (PET-CT). It provides information about lymph node (LN) location, enlargement, and metabolic activity as measured by the maximum standardized uptake value (SUVmax). However, more definitive information can only be obtained by direct sampling through cervical mediastinoscopy (Med) and/or endobronchial ultrasound-guided transbronchial needle aspiration (EBUS). There remains discrepancy when comparing the diagnostic accuracy of these two methods for detecting nodal metastasis. Further, there is inadequate data on the value of SUVmax magnitude in predicting nodal metastasis by EBUS.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    This was a retrospective analysis of 148 biopsy-confirmed NSCLC patients who underwent Med and/or EBUS for staging purposes from 2010-2015 (2013 excluded). Two groups matched by age, sex, and year of procedure were analyzed to determine if the diagnostic accuracy was comparable between the two methods. Primary tumour and LN SUVmax was correlated with the likelihood of finding LN metastasis by either method. Chi-squared tests and Student's t-tests were used to assess for significance where appropriate.

    4c3880bb027f159e801041b1021e88e8 Result
    

    The mean SUVmax of true positive LNs was significantly higher than true negative LNs sampled by EBUS (7.77 vs. 4.06, p=0.0047, t-test). Among PET-positive LNs, there was a significant correlation between likelihood of positive findings by EBUS and increased SUVmax>4 (p=0.018, Chi-squared test). There were no significant differences between Med and EBUS in sensitivity, specificity, PPV, or NPV. However, Med had significantly higher diagnostic yield (p<0.0001, Chi-squared test).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Our results suggest that among PET-positive LNs, there is a significant correlation between SUVmax magnitude and likelihood of detecting true LN metastasis by EBUS. Additional studies should aim to further characterize this relationship.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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