Clinical Research Papers:
Radial EBUS versus CT-guided needle biopsy for evaluation of solitary pulmonary nodules
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Wei Wang1,2,3, Like Yu1,2,3, Yuchao Wang1,2,3, Qian Zhang1,2,3, Chuanzhen Chi1,2,3, Ping Zhan1,2,3 and Chunhua Xu1,2,3
1Endoscopic Center of Nanjing Chest Hospital, Nanjing, 210009, Jiangsu, China
2Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, 210009, China
3Department of Respiratory Medicine, The Affiliated Hospital of Southeast University, Nanjing, Jiangsu 210009, China
Chunhua Xu, email: [email protected]
Keywords: solitary pulmonary nodule; endobroncheal ultrasonography guided bronchoscopy; ct guided percutaneous needle biopsy; diagnostic yield; complication
Received: February 08, 2017 Accepted: November 16, 2017 Epub: January 04, 2018 Published: March 13, 2018
Objective: This study is aimed to compare the diagnostic yield, complications and influencing factors between Radial endobroncheal ultrasonography guided bronchoscopy(R-EBUS) and CT-guided needle biopsy (CT-PNB), for evaluation of solitary pulmonary nodules(SPNs).
Matrials and Methods: 160 cases of consecutive patients with SPNs were enrolled and divided into R-EBUS and CT-PNB groups randomly. The diagnostic yield, complications and influencing factors between the two groups were evaluated.
Results: Sensitivity of R-EBUS for malignancy was 73.7% (42/57) and for benign, was 43.5% (10/23), overall diagnostic accuracy was 65% (52/80). In CT-PNB group, overall diagnostic accuracy was 85% (68/80), sensitivity for malignancy was 87.9% (51/58), and for benign was 81.0% (17/21), respectively. Both overall diagnostic yield and incidence of complications in CT-PNB group were higher than those in R-EBUS group (P = 0.006, P = 0.002). In R-EBUS group, the factors affecting diagnostic yield were size (P = 0.027), the distance between SPNs and pleura (P = 0.031) and the location of the probe to lesions (P = 0.009). In CT-PNB group, the distance from the lesions to pleura was correlated with the incidence of pneumothorax (P = 0.001) and pulmonary haemorrhage (P = 0.042). The location of SPNs were adjacent to great vessels was another influencing factor for pulmonary haemorrhage (P = 0.042).
Conclusions: Both R-EBUS and CT-PNB are valuable tools for diagnosis. SPNs located in medial 1/2 of lung field, or were adjacent to great vessels may be fit for R-EBUS. Those SPNs located in lateral 1/2 of lung field, near to pleura or with less vessels around may be more suitable for CT-PNB.
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