help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on August 6, 2003, doi:10.1164/rccm.200301-050OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 11, December 2003, 1293-1297

A more recent version of this article appeared on December 1, 2003
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200301-050OCv1
168/11/1293    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fritscher-Ravens, A.
Right arrow Articles by Pforte, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fritscher-Ravens, A.
Right arrow Articles by Pforte, A.

Submitted on January 13, 2003
Accepted on August 5, 2003

Endoscopic ultrasound, positron emission tomography, and computerized tomography for lung cancer

Annette Fritscher-Ravens1, Bruce L Davidson2*, Hans-Peter Hauber3, Karl H Bohuslavizki4, C Bobrowski3, Christian Lund5, Wolfram Trudo Knofel6, Nib Soehendra1, Lars Brandt1, Margaret S Pepe7, and Almuth Pforte3

1 Interdisciplinary Endoscopy, University Hospital, Eppendorf, Hamburg, Germany, 2 Pulmonary-Critical Care Division, University of Washington School of Medicine and Swedish Medical Center, Seattle, WA, USA, 3 Internal Medicine, Pulmonology, University Hospital, Eppendorf, Hamburg, Germany, 4 Nuclear Medicine, University Hospital, Eppendorf, Hamburg, Germany, 5 Radiology, University Hospital, Eppendorf, Hamburg, Germany, 6 General Surgery, University Hospital, Eppendorf, Hamburg, Germany, 7 Biostatistics, University of Washington School of Public Health, Seattle, WA, USA

* To whom correspondence should be addressed. E-mail: brucedavidson{at}pobox.com.

Staging of lung cancer patients to determine operability is intended to efficiently limit futile thoracotomies without denying possibly curative surgery. Currently available staging tests are imperfect alone and in combination. Imaged suspected metastases often require tissue confirmation before surgery can be denied. Endoscopic ultrasound may help identify inoperable patients by providing tissue proof of inoperability in a single staging test, with similar sensitivity for identifying inoperable patients as other staging tests. Therefore, we compared computed tomography, positron emission tomography, and endoscopic ultrasound with fine needle aspiration under conscious sedation, each test interpreted blinded with respect to the other tests, for identifying inoperable patients in a consecutive cohort of 79 potentially operable patients with suspected or proven lung cancer. An economic analysis was also performed. 39 patients were found inoperable (a 40th patients inoperability was missed by all preoperative staging tests). The sensitivity of computerized tomography was 43%. Positron emission tomography and endoscopic ultrasound each had similar sensitivities (68% and 63%, respectively) and similar negative predictive values (64% and 68%, respectively), but endoscopic ultrasounds superior specificity (100% vs 72% for positron emission tomography) and considerably lower expense means it may be preferred to positron emission tomography early in staging to identify inoperable patients.
Key words: staging, mediastinum, metastasis, cost effectiveness, operability




This article has been cited by other articles:


Home page
 ChestHome page
M. S. Sawhney, Y. Bakman, A. M. Holmstrom, D. B. Nelson, F. A. Lederle, and R. F. Kelly
Impact of Preoperative Endoscopic Ultrasound on Non-small Cell Lung Cancer Staging
Chest, September 1, 2007; 132(3): 916 - 921.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
F. C. Detterbeck, M. A. Jantz, M. Wallace, J. Vansteenkiste, and G. A. Silvestri
Invasive Mediastinal Staging of Lung Cancer: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition)
Chest, September 1, 2007; 132(3_suppl): 202S - 220S.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. Singh, B. Camazine, Y. Jadhav, R. Gupta, P. Mukhopadhyay, A. Khan, R. Reddy, Q. Zheng, D. D. Smith, R. Khode, et al.
Endoscopic Ultrasound As a First Test for Diagnosis and Staging of Lung Cancer: A Prospective Study
Am. J. Respir. Crit. Care Med., February 15, 2007; 175(4): 345 - 354.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
C. G. Micames, D. C. McCrory, D. A. Pavey, P. S. Jowell, and F. G. Gress
Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Non-small Cell Lung Cancer Staging: A Systematic Review and Metaanalysis
Chest, February 1, 2007; 131(2): 539 - 548.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. Lemaire, I. Nikolic, T. Petersen, J. C. Haney, E. M. Toloza, D. H. Harpole Jr, T. A. D'Amico, and W. R. Burfeind
Nine-year single center experience with cervical mediastinoscopy: complications and false negative rate.
Ann. Thorac. Surg., October 1, 2006; 82(4): 1185 - 1190.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
K. Yasufuku, T. Nakajima, K. Motoori, Y. Sekine, K. Shibuya, K. Hiroshima, and T. Fujisawa
Comparison of Endobronchial Ultrasound, Positron Emission Tomography, and CT for Lymph Node Staging of Lung Cancer.
Chest, September 1, 2006; 130(3): 710 - 718.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
V. W. Rusch
Mediastinoscopy: An Endangered Species?
J. Clin. Oncol., November 20, 2005; 23(33): 8283 - 8285.
[Full Text] [PDF]

Home page
 ChestHome page
K. G. Tournoy, M. M. Praet, G. Van Maele, and J. P. Van Meerbeeck
Esophageal Endoscopic Ultrasound With Fine-Needle Aspiration With an On-site Cytopathologist: High Accuracy for the Diagnosis of Mediastinal Lymphadenopathy
Chest, October 1, 2005; 128(4): 3004 - 3009.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
J. T. Annema, M. I. Versteegh, M. Veselic, L. Welker, T. Mauad, J. K. Sont, L. N. A. Willems, and K. F. Rabe
Endoscopic Ultrasound Added to Mediastinoscopy for Preoperative Staging of Patients With Lung Cancer
JAMA, August 24, 2005; 294(8): 931 - 936.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
C. T. Bolliger
EUS: confusion about terminology and its consequences
Eur. Respir. J., July 1, 2005; 26(1): 182 - 183.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
P. Vilmann and S. S. Larsen
Endoscopic ultrasound-guided biopsy in the chest: little to lose, much to gain
Eur. Respir. J., March 1, 2005; 25(3): 400 - 401.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. K. LeBlanc, B. M. Devereaux, T. F. Imperiale, K. Kesler, J. M. DeWitt, O. Cummings, D. Ciaccia, S. Sherman, P. Mathur, D. Conces, et al.
Endoscopic Ultrasound in Non-Small Cell Lung Cancer and Negative Mediastinum on Computed Tomography
Am. J. Respir. Crit. Care Med., January 15, 2005; 171(2): 177 - 182.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
L. Schrevens, N. Lorent, C. Dooms, and J. Vansteenkiste
The Role of PET Scan in Diagnosis, Staging, and Management of Non-Small Cell Lung Cancer
Oncologist, November 1, 2004; 9(6): 633 - 643.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Sleep-Disordered Breathing, Control of Breathing, Respiratory Muscles, Pulmonary Function Testing in AJRCCM 2003
Am. J. Respir. Crit. Care Med., January 15, 2004; 169(2): 254 - 264.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Chronic Obstructive Pulmonary Disease, Pollution, Pulmonary Vascular Disease, Transplantation, Pleural Disease, and Lung Cancer in AJRCCM 2003
Am. J. Respir. Crit. Care Med., January 15, 2004; 169(2): 301 - 313.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. A. Kern
Sounding the Mediastinum
Am. J. Respir. Crit. Care Med., December 1, 2003; 168(11): 1261 - 1262.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2003 American Thoracic Society 		  ATS Par News