Page 82 - ECBIP 2021_Program

6th European Congress ECBIP 15 - 17
Book of Abstracts
for Bronchology and
Interventional Pulmonology ATHENS - GREECE 2021
OCTOBER
MODERATED e-POSTER SESSION 08:
Novel Imaging modalities
NEEDLE BASED CONFOCAL LASER ENDOMICROSCOPY FOR THE DIAGNOSIS OF PERIPHERAL LUNG NODULES BY ROBOTIC NAVIGATIONAL BRONCHOSCOPY Christopher Manley1*, Tess Kramer2*, Rohit Kumar1, Lizzy Wijmans2, Martijn de Bruin2, Eric Ross3,Yulan Gong4, Hormoz Ehya4, Peter I. Bonta2, Jouke Annema2
1 Department of Pulmonary and Critical Care, Fox Chase Cancer Center, Philadelphia PA, USA 2 Department of Respiratory Medicine, Amsterdam UMC, Amsterdam, Netherlands
3 Department of Statistics, Fox Chase Cancer Center, Philadelphia PA, USA
4 Department of Pathology, Fox Chase Cancer Center, Philadelphia PA, USA
*Shared first author
PP54
Introduction: Robotic bronchoscopy (RB) allows for high navigational success but diagnostic yield remains moderate due to near-miss of the target lesion. Needle based confocal laser endomicroscopy (nCLE) allows for real-time microscopic lung cancer detection at the tip of the biopsy needle. We aim to assess feasibility, safety and needle repositioning based on nCLE-guidance during robotic bronchoscopy to reduce the current near-miss rate.
Methods: Patients with suspected peripheral lung cancer based on (PET-)CT-scan underwent fluoroscopy and radial EBUS guided robotic bronchoscopy. After bronchoscopic lesion identification, an 18G needle containing the CLE probe imaged the target area, followed by TBNA and biopsies. In case of non-lesional nCLE-imaging, readjustment of the robotic bronchoscope was performed.
Results: 17 patients were included (final diagnosis n=15 cancer, n=1 epitheliod granuloma, n =1 non-diagnostic) with a mean lesion size of 15 mm (range 8-30 mm). No complications occurred. In 14/15 (93%) of patients with cancer, nCLE-imaging detected a malignant nCLE pattern. In one patient alveolar parenchyma/ airway wall was visualized. One patient with a malignant nCLE pattern but negative robotic bronchoscopic lesion sampling, was diagnosed with malignancy after surgery. In 6 patients (35%), nCLE guidance resulted in readjustment of the robotic bronchoscope with optimization of the sampling location, resulting in a diagnostic yield of 82%, (14/17, 13 patients with malignancy and 1 patient with epithelioid granuloma).
Conclusion: In conclusion, robotic bronchoscopy combined with nCLE-imaging is feasible, safe and can serve as a real- time guidance tool to fine-tune the sampling location to improve the diagnosis of peripheral lung cancer.
PP56
Objective: This study aims to investigate the diagnostic role of endobronchial ultrasonography elastography features in predicting malignancy.
Methods: Between January 2017 and March 2020, a total of 385 lymph nodes were biopsied using the endobronchial ultrasonography-guided transbronchial needle aspiration from 224 consecutive patients (158 males, 66 females; mean age 61.2±12.4 years; range, 28 to 85 years) were included. Lymph nodes were scored by elastography according to their colors in three categories before the procedure.The strain ratio was calculated based on the region of interest after three measurements.
Results: Of the 385 lymphnodes, 228 were diagnosed with a malignancy through endobronchial ultrasonography-guided transbronchial needle aspiration biopsy. The mean lymph node score of benign versus malignant lesions was 1.5±0.6 and 2.6±0.6, respectively (p<0.001). There was a positive correlation between the lymph node scores and lymph node diameter, strain ratio, color score, shape, vascularity and fluorodeoxyglucose uptake value (p<0.01).The mean strain ratio for malignant and benign lymph nodes was 41.8±33.6 and 8.9±18.2, respectively (p<0.001). With a cut-off value of ≥6.5 of strain ratio, the sensitivity for malignancy was 88.1% and specificity was 83.7%.
Conclusion: This prospective study showed that Endobronchial ultrasonography elastography is useful in predicting malignancy of the lymph nodes when combined with the strain ratio.
THE ROLE OF ENDOBRONCHIAL ULTRASOUND ELASTOGRAPHY IN THE CHARACTERIZATION OF MEDIASTINAL LYMPHADENOPATHY: A SINGLE-CENTER, PROSPECTIVE, OBSERVATIONAL STUDY
Nilgun Yılmaz Demirci, Asiye Ugras Dikmen, Ayshan Mammadova, Ahmet Selim Yurdakul, Can Öztürk
Gazi University Faculty of Medicine,Ankara,Turkey
82 6th European Congress for Bronchology and Interventional Pulmonology