Background: To demonstrate the diagnostic accuracy of an integrated approach of blind trans-bronchial needle aspiration (TBNA) and Tc-99m-2-methoxy-isobutyl-isonitrile single photon emission computed tomography (Tc-99m-MIBI-SPECT) in diagnosing mediastinal lymph adenopathy.Methods: Sixty one consecutive patients with mediastinal lymph adenopathy undergoing both TBNA and Tc-99m-MIBI-SPECT were prospectively enrolled. Mediastinoscopy was attended in case of negative TBNA.Results: Eighty three adenopathies were sampled (73 malignant and 10 benign). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of TBNA was 74%, 100%, 100%, and 34%, respectively; and of Tc-99m-MIBI-SPECT was 96%, 80%, 97%, and 73%, respectively. Combining TBNA and Tc-99m-MIBI-SPECT results sensitivity, specificity, PPV, NPV of 97%, 100%, 100%, and 83%, respectively, was obtained. TBNA alone avoided medistianoscopy in 65% of cases, while an integrated approach could haveConclusions: Tc-99m-MIBI-SPECT improved the sensitivity and the NPV of TBNA, reducing the need of mediastinoscopy. (C) 2013 SEPAR. Published by Elsevier Espana, S.L. All rights reserved.

Combined Transbronchial Needle Aspiration and Tc-99m-2-Methoxy-Isobutyl-Isonitrile Single Photon Emission Computed Tomography for Diagnosing Enlarged Mediastinal Lymph Nodes

FIORELLI, Alfonso;RAMBALDI, Pier Francesco;VICIDOMINI, Giovanni;ACCARDO, Marina;ROTONDO, Antonio;SANTINI, Mario
2014

Abstract

Background: To demonstrate the diagnostic accuracy of an integrated approach of blind trans-bronchial needle aspiration (TBNA) and Tc-99m-2-methoxy-isobutyl-isonitrile single photon emission computed tomography (Tc-99m-MIBI-SPECT) in diagnosing mediastinal lymph adenopathy.Methods: Sixty one consecutive patients with mediastinal lymph adenopathy undergoing both TBNA and Tc-99m-MIBI-SPECT were prospectively enrolled. Mediastinoscopy was attended in case of negative TBNA.Results: Eighty three adenopathies were sampled (73 malignant and 10 benign). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of TBNA was 74%, 100%, 100%, and 34%, respectively; and of Tc-99m-MIBI-SPECT was 96%, 80%, 97%, and 73%, respectively. Combining TBNA and Tc-99m-MIBI-SPECT results sensitivity, specificity, PPV, NPV of 97%, 100%, 100%, and 83%, respectively, was obtained. TBNA alone avoided medistianoscopy in 65% of cases, while an integrated approach could haveConclusions: Tc-99m-MIBI-SPECT improved the sensitivity and the NPV of TBNA, reducing the need of mediastinoscopy. (C) 2013 SEPAR. Published by Elsevier Espana, S.L. All rights reserved.
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11591/227549
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 3
social impact