Lung Malignancies, Mediastinal Lymphadenopathy
Conditions
Keywords
FDG-PET/CT, lung cancer, lung staging, EBUS-TBNA, mediastinal lymphadenopathy
Brief summary
Lung cancer is a prevalent cause of cancer-related mortality on a global scale. Appropriate staging of lung cancer is of paramount importance, as it customizes treatment and predicts prognosis. Fludeoxyglucose-18 (FDG) positron emission tomography (PET) combined with low dose contrast computed tomography (CT) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are two diagnostic modalities widely used in the field of staging & diagnosis of lung malignancies, the former depends on image analysis while the later enables real-time sampling of lymph nodes under sonographic guidance with concurrent cytological examination. The present research aims to compare the diagnostic and staging accuracies of (EBUS-TBNA) versus FDG-PET /CT as two diagnostic modalities in patients with suspected lung malignancies. However as a secondary outcome this study aims at monitoring the possible complications arising post EBUS-TBNA procedure.
Detailed description
Lung cancer is a prevalent cause of cancer-related mortality on a global scale. Appropriate staging of lung cancer is of paramount importance, as it customizes treatment and predicts prognosis. Fludeoxyglucose-18 (FDG) positron emission tomography (PET) combined with low dose contrast computed tomography (CT) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are two diagnostic modalities widely used in the field of staging & diagnosis of lung malignancies, the former depends on image analysis while the later enables real-time sampling of lymph nodes under sonographic guidance with concurrent cytological examination. Objective: To compare the diagnostic and staging accuracy of convex probe EBUS-TBNA versus FDG - PET/CT as two diagnostic modalities in diagnosis of suspected lung cancer & staging of concurrent mediastinal lymphadenopathy Patients and Methods: This prospective, interventional cohort research was performed on 40 cases with suspected lung malignancies. All cases were examined via FDG-PET/CT followed by convex probe EBUS-TBNA for diagnosis of suspected lung cancer & staging of concurrent mediastinal lymphadenopathy.
Interventions
DIAGNOSTIC_TESTEndo bronchial ultrasound transbronchial needle aspiration(EBUS-TBNA)
Endo bronchial ultrasound enables visualization of parabronchial structures throughout a bronchoscopic procedure. EBUS-TBNA, which is considered a less invasive diagnostic tool for nodal staging compared to mediastinoscopy, allows real-time, direct sampling of hilar & MLNs under sonograghic guidance with concurrent cytological and histopathological examination
Sponsors
Ain Shams University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
This prospective, interventional cohort research was performed on 40 cases with suspected lung malignancies. All cases were examined via FDG-PET/CT followed by convex probe EBUS-TBNA for diagnosis of suspected lung cancer & staging of concurrent mediastinal lymphadenopathy.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients 18 years old or more. * Patients presented with centrally located suspiciously malignant lung masses with or without lymphadenopathy. * patients with mediastinal lymphadenopathy only as evident by contrast - enhanced CT scan of the chest. * patients with peripheral lung malignancy and mediastinal lymphadenopathy who were referred for MLN staging were also recruited to the research
Exclusion criteria
* All patients who were who were unfit for bronchoscopy as per international guidelines for practice. * Cases are diagnosed with stage IV (metastatic) lung cancer. * Patients with histopathological diagnosis other than malignancy (as Sarcoidosis, Tuberculosis). * patients unfit for FDG-PET G-PET/CT examination (uncontrolled Hyperglycemia, renal impairment). * Patients who refused to participate to the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparing the diagnostic accuracies of both EBUS TBNA and FDG-PET /CT | 2 years | Comparing the diagnostic yield of both modalies as they are considered primary main diagnostic and staging modalities for lung malignancies |
| Comparing the staging accuracies of both convex probe EBUS-TBNA versus FDG - PET/CT | 2 years | Accurate staging of lung malignancies is considered crucial in determining the prognosis and specifying the treatment plan. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Determine the complications | 2 years | EBUS TBNA is a minimally invasive procedure having a very low rate of complications compared to mediastinoscopy, this study aims to monitor complications (if present) |
Countries
Egypt
Outcome results
None listed