Pet/bt and combined transbronchial needle aspiration and pet/bt for staging of lung cancer

In our study, we evaluate the performance of combined transbronchial needle aspiration and PET/BT for staging of lung cancer and decreasing need for mediastinoscopy. A total of 25 patients with enlarged mediastinal lymph nodes (?1 cm), who underwent PET scanning (SUV max ?2.5) were included. TBİA was performed in all 25 patients from 43 lymph nodes. Surgical histology confirmed by mediastinoscopy was used ?gold standart?. The sensitivity, specificity, positive predictive value, negative predictive value of TBIA were; %87, %100, %100, %89 for correct diagnosis of lymph node staging, respectively. The initial clinical staging was changed after TBİA in 13/19 (%69) patients who have adequate TBIA samples. The correct staging was done with TBİA in 17/19 (%89) patients who have adequate TBIA samples. The staging was completed with TBIA in 5/19 (%26) patients without mediastinoscopy. The clinical factors that might effect positive TBİA result were analysed and found that only value of PET SUV max effects positive TBİA result [OR=1.27 (1.004-1.610), p=0.046]. The PET SUV max ? 5 was 11 times increased positive TBİA results [OR=10.68 (1.91-59.62), p<0.01].In conclusion, TBİA is less invaziv procedure, have less complication than mediastinoscopy and should be considered for staging of lung cancer. TBİA is able to preclude the need for mediastinoscopy. Combination of TBİA with PET/BT increases sensitivity of TBİA. The cut off point was SUV max? 5 for positive TBİA value.Key words: Lung cancer, Staging, TBNA, PET/BT