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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 OutcomeImaging Modality | Number of Patients | Percent Diagnosed with a Malignancy | CT only | 21/33 | 63.6% | PET only | 8/15 | 53.3% | CT and PET | 13/29 | 44.8% | | | p= 0.332 by Fisher’s exact test | Imaging Finding | Number of Patients | Percent Diagnosed with a Malignancy | Mediastinal Adenopathy or Hilar Adenopathy Alone | 10/24 | 41.7% | Lung Nodule Alone | 2/7 | 28.6% | Lung Nodule with Another Finding | 29/45 | 64.4% | | | p= 0.067 by Fisher’s exact test |
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