Thoracic endosonography (EBUS/EUS-b). A single center retrospective analysis

Abstract

Introduction: EBUS/EUS-b is an accurate and minimally invasive technique used primarily for diagnosis and staging of lung cancer (LC).

Aim: To evaluate the role of EBUS/EUS-b in different thoracic diseases and calculate its sensitivity, specificity, positive and negative predictive values.

Methods: Retrospective analysis of patients that underwent EBUS/EUS-b in our center between 2016 and 2019 was performed.

Results: A total of 266 patients were enrolled (70,9% males, 85,7% smokers, mean age± SD: 62,8±7,6 years). Chest CT prior EBUS/EUS-b was available in 56% of patients and integrated PET-CT in the remaining 44%. Diagnosis and staging of suspected LC were the main indications for EBUS/EUS-b (63,5%), followed by staging of proven LC (5,3%), evaluation of possible LC recurrence (10,9%), diagnosis of sarcoidosis (30,1%) and lymphoma (5,3%). EUS-b was performed in 14,7% of patients. LN 7 was the most frequently assessed station (79,7%), followed by LN4R (50,2%) and LN 10-11L (25,5%). Diagnosis with EBUS/EUS-b was achieved in 67,7% of patients. Most cases (50,8%) were malignancies (46,3% adenocarcinoma, 17,9% squamous cell, 8,9% NSCLC-NOS, 16,4% SCLC and 1,5% lymphomas), while 18,1% of cases represented benign diseases (83,3% sarcoidosis, 12,5% tuberculosis). Sensitivity, specificity, PPV and NPV for cases suspected for malignancy were 90,5%, 100%, 100%, and 65,9% respectively. With regards to sarcoidosis, sensitivity and PPV were 95,2% and 100% respectively.

Conclusion: Our study confirms that thoracic endosonography is a safe, minimally invasive procedure with high sensitivity and diagnostic accuracy in patients with suspected malignancy and mediastinal lymphadenopathy.