(18)F-Fdg Uptake Predicts Diagnostic Yield of Transbronchial Biopsy in Peripheral Lung Cancer.
(18)F-Fdg Uptake Predicts Diagnostic Yield of Transbronchial Biopsy in Peripheral Lung Cancer.
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(18)F-Fdg 摄取可预测周围肺癌经支气管活检的诊断率。
DOI：
10.1016/j.lungcan.2014.03.025
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发表时间：
2014
期刊：
影响因子：
5.3
通讯作者：
and T. Ishizuka.
中科院分区：
文献类型：
--
作者：
6.Umeda;Y.;Y. Demura;M. Anzai;H. Matsuoka;T. Araya;M. Nishitsuji;K. Nishi;T. Tsuchida;Y. Sumida;M. Morikawa;S. Ameshima;T. Ishizaki;K. Kasahara;and T. Ishizuka.
目的引导鞘支气管腔内超声(EBUS-GS)的最新进展使远端气道得到了更好的可视化，而虚拟支气管镜导航(VBN)已被证明是导航支气管镜的有用指南。然而，使用VBN和EBUS-GS的迹象并不总是明确的。为明确周围型肺癌支气管镜检查的适应证，我们评价了预测经纤维支气管镜活检诊断周围型肺癌的因素。方法回顾194例周围型肺癌患者201个病灶(平均直径≤3 cm)的诊断结果，分析18F-脱氧葡萄糖(18F-FDG)正电子发射断层扫描和胸部计算机断层扫描(CT)结果对周围型肺癌诊断效率的影响。高标准摄取值(SUVmax)、阳性支气管征和磨玻璃样阴影均是诊断成功率的显著预测因素，而多因素分析仅显示高摄取率(SUVmax≥2.8)和阳性支气管征是有意义的预测因素。高摄取率(SUVmax≥2.8)和阳性支气管征(84.6%)的肝癌病变的诊断率高于摄取高摄取率(SUVmax 2.8)和支气管征阴性(33.3%)的患者。高18F-FDG摄取与肿瘤侵袭性相关。结论高18F-FDG摄取可预测VBN和EBUS-GS对肝癌的诊断价值，18F-FDG摄取和支气管征有助于准确应用支气管镜诊断肝癌。
ObjectivesRecent advances in endobronchial ultrasonography with a guide sheath (EBUS-GS) have enabled better visualization of distal airways, while virtual bronchoscopic navigation (VBN) has been shown useful as a guide to navigate the bronchoscope. However, indications for utilizing VBN and EBUS-GS are not always clear. To clarify indications for a bronchoscopic examination using VBN and EBUS-GS, we evaluated factors that predict the diagnostic yield of a transbronchial biopsy (TBB) procedure for peripheral lung cancer (PLC) lesions.MethodsWe retrospectively reviewed the charts of 194 patients with 201 PLC lesions (≤3 cm mean diameter), and analyzed the association of diagnostic yield of TBB with [18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography and chest computed tomography (CT) findings.ResultsThe diagnostic yield of TBB using VBN and EBUS-GS was 66.7%. High maximum standardized uptake value (SUVmax), positive bronchus sign, and ground-glass opacity component shown on CT were all significant predictors of diagnostic yield, while multivariate analysis showed only high18F-FDG uptake (SUVmax ≥2.8) and positive bronchus sign as significant predictors. Diagnostic yield was higher for PLC lesions with high18F-FDG uptake (SUVmax ≥2.8) and positive bronchus sign (84.6%) than for those with SUVmax <2.8 and negative bronchus sign (33.3%). High18F-FDG uptake was also correlated with tumor invasiveness.ConclusionsHigh18F-FDG uptake predicted the diagnostic yield of TBB using VBN and EBUS-GS for PLC lesions.18F-FDG uptake and bronchus sign may indicate for the accurate application of bronchoscopy with those modalities for diagnosing PLC.