Background/Objectives: The prevalence of lung cancer in patients with a peripheral pulmonary nodule referred for navigation bronchoscopy (NB) is high. Combining NB with a systematic EBUS for staging is common practice. We investigated the added value of performing EBUS in the population referred for NB in relation to the available pre-procedural [18F]FDG-PET and CT imaging information. Methods: This single-center study evaluated all consecutive patients who underwent an NB in an academic referral center. [18F]FDG-PET and CT scoring of lymphadenopathy was based on routine [18F]FDG-PET and/or contrast-enhanced chest (ce) CT imaging reports and were correlated to outcome of systematic EBUS and subsequent surgery (when available). Results: In total, 403 patients were included for analysis of which 327 underwent EBUS (81.1%). In 138/403 patients (35%) who had positive lymph nodes on [18F]FDG-PET (86.5%) or ceCT (13.5%), 12 lung cancer patients were diagnosed with N+ disease by EBUS (8.4%). An additional nine EBUS-negative patients were diagnosed with N+ disease after surgery (5.4%). In the group of patients with imaging-negative lymph nodes (65.8%), no metastatic lymph nodes were found by EBUS, and surgery revealed occult nodal metastasis in eight patients (3.1%). Conclusions: In patients with peripheral pulmonary nodules referred for NB, EBUS may be safely omitted when [18F]FDG-PET or ceCT imaging does not indicate presence of nodal involvement.
背景/目的：在接受导航支气管镜检查（NB）的外周肺结节患者中，肺癌的患病率较高。将NB与系统性支气管内超声（EBUS）分期相结合是常见做法。本研究探讨了在转诊接受NB的患者群体中，结合已有的术前[18F]FDG-PET和CT影像信息，进行EBUS检查的附加价值。方法：这项单中心研究评估了在一家学术转诊中心连续接受NB的所有患者。淋巴结病变的[18F]FDG-PET和CT评分基于常规[18F]FDG-PET和/或增强胸部CT影像报告，并与系统性EBUS及后续手术（如可行）的结果进行关联分析。结果：共纳入403例患者进行分析，其中327例接受了EBUS检查（81.1%）。在138例（35%）[18F]FDG-PET（86.5%）或增强CT（13.5%）显示淋巴结阳性的患者中，EBUS诊断出12例肺癌患者存在N+疾病（8.4%）。另有9例EBUS阴性的患者术后诊断为N+疾病（5.4%）。在影像学淋巴结阴性组（65.8%）中，EBUS未发现转移性淋巴结，但手术发现8例患者存在隐匿性淋巴结转移（3.1%）。结论：对于转诊接受NB的外周肺结节患者，当[18F]FDG-PET或增强CT影像未提示淋巴结受累时，可安全省略EBUS检查。
肿瘤(癌症)患者之家