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Using Endobronchial Ultrasound to Elucidate Findings on Surveillance PET and CT Scans in Patients with a History of Malignancy
*Bryan Payne Stanifer, *Piroska K Kopar, *Anne K McGowan, *James R Rigas, *Peter A Delong, *Vijayalakshmi Padmanabhan4, William C Nugent, *Konstantin H Dragnev, *Cherie P Erkmen
Dartmouth-Hitchcock Medical Center, Lebanon, NH

Objective: Patients with a history of malignancy often receive endobronchial ultrasound (EBUS) to elucidate findings on surveillance imaging. The purpose of this abstract is to identify how imaging characteristics relate to malignancy.
Design: This is a single-institution, retrospective review of all patients who underwent EBUS with a previous history of malignancy between 2008 and 2010. Fisher’s exact test was used to compare categorical data.
Setting: Tertiary referral center.
Patients: 77 (39.3%) patients with a previous malignancy out of 196 total patients receiving EBUS.
Interventions: The patients underwent EBUS in addition to a CT or PET scan.
Main Outcome Measures: Diagnosis of malignancy.
Results: There were 16 cases of lung cancer and 65 cases of non-lung cancer in these patients prior to their evaluation. There were 43 (55.8%) men.
All patients underwent imaging prior to EBUS. In total, 42.9% underwent CT scan alone, 19.5% underwent PET scan alone, and 37.7% underwent both a CT and PET scan.
Of the 77 patients with a previous malignancy, EBUS diagnosed 41 (53.2%) with malignancy. Of these 41 patients, 34 (82.9%) were diagnosed with a new or recurrent lung cancer.

Conclusions: Over half of patients will have a malignancy diagnosed, the most common of which is lung cancer. Neither CT nor PET seemed superior.
Imaging and Outcome
Imaging ModalityNumber of PatientsPercent Diagnosed with a Malignancy
CT only21/3363.6%
PET only8/1553.3%
CT and PET13/2944.8%
p= 0.332 by Fisher’s exact test
Imaging FindingNumber of PatientsPercent Diagnosed with a Malignancy
Mediastinal Adenopathy or Hilar Adenopathy Alone10/2441.7%
Lung Nodule Alone2/728.6%
Lung Nodule with Another Finding29/4564.4%
p= 0.067 by Fisher’s exact test

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Abstract Submission Deadline:
May 5, 2014

Housing Deadline:
August 13, 2014

Early Bird Registration Deadline:
August 11, 2014
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