Source: Annual Congress 2002 - Thoracic ultrasound and photodynamic therapy
Disease area: Respiratory infections, Thoracic oncology

Abstract

Introduction: Endobronchial ultrasound (EBUS) is a new diagnostic tool for evaluation of central peribronchial lesions. The usefulness of EBUS for peripheral lesions is not clear.
Methods: EBUS was performed in patients with peripheral lesions by a 12MHz-probe (Olympus UM-2R). The lesions were localised by EBUS and transbronchial biopsy and/or fine-needle aspiration and/or brushings were done. The diameter was defined by the longest axis on CT-scan. Patients were divided into two groups: Group A) with detectable and group B) with non-detectable lesions by EBUS.
Results: Between 1/97 and 11/01 90 patients with peripheral lesions underwent EBUS. The mean age (±]SD) was 64±]12 years, 21% were female. 69 of 90 (76%) lesions were detectable by EBUS (group A).
In group A 54% (37/69) lesions were localised in the upper lobe compared to 57% (11/21) in group B. Lesions size was less than 3cm in 48% of group A and 57% of group B, 3 to 5cm in 36% and 43%, respectively. All 11 (16%) lesions greater than 5cm were detectable by EBUS. The diagnostic yield in all patients was 57% (51/90) and in patients with detectable lesions 74% (51/69). It increased with size (<3cm 47%, 3-5cm 69%, >5cm 73%). The final diagnosis of the 51 positive examinations was: 72% non small-cell lung cancer, 4% metastases, 2% lymphoma and 22% benign pathology (confirmed by clinical follow-up: pneumonia 5/11, tuberculosis 2/11, MOTT 1/11, actinomycosis 1/11, COP 2/11).
Conclusion: With the additional use of EBUS a final diagnosis could be established in 57% of all examinations and in 74% of detectable lesions, respectively. The localisation had no significant influence on the detection rate, the diagnostic yield increased with size of the lesion. The additional use of EBUS improves bronchoscopic evaluation of peripheral lesions.

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Citations should be made in the following way:
C. Loeschhorn, M. Hofer, T. Hess (Winterthur, Switzerland). Endobronchial ultrasonography for evaluation of peripheral pulmonary lesions: a retrospective analysis. Eur Respir J 2002; 20: Suppl. 38, 3718

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