Scholarlink

Background <p>This study aimed to identify clinical predictors of diagnostic sensitivity for malignancy in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and to determine optimal cut-off values for preoperative imaging parameters. We retrospectively reviewed 124 patients who underwent EBUS-TBNA for suspected thoracic malignancy between 2019 and 2022. Among 93 patients with available 18&#xa0;F-fluorodeoxyglucose positron emission tomography/ computed tomography (FDG-PET/CT) and confirmed malignancy, the association between EBUS-TBNA diagnostic positivity and clinical factors, including CT nodal long-axis diameter and maximum standardized uptake value (SUVmax), was analyzed. Optimal cut-off values were determined using receiver operating characteristic (ROC) curve analysis.</p> Results <p>Of the 93 patients analyzed, 75 (80.6%) were diagnosed via EBUS-TBNA (EBUS-positive group), while 18 (19.4%) were false negatives (EBUS-false-negative group). Multivariable logistic regression analysis, treating parameters as continuous variables, identified both nodal size (odds ratio [OR]: 1.150; 95% confidence interval [CI]: 1.030–1.290; <i>p</i> = 0.016) and SUVmax (OR: 1.170; 95% CI: 1.020–1.330; <i>p</i> = 0.021) as significant independent predictors of EBUS-TBNA positivity. ROC analysis established optimal cut-offs of 21&#xa0;mm for nodal size (AUC: 0.802) and 7.9 for SUVmax (AUC: 0.805). When both criteria (nodal size ≥ 21&#xa0;mm and SUVmax ≥ 7.9) were met, the positive predictive value reached 95.7%, with a diagnostic accuracy of 64.5% and a negative predictive value of 34.0%.</p> Conclusions <p>The combination of high metabolic activity (SUVmax ≥ 7.9) and nodal size (≥ 21&#xa0;mm) serves as a predictor of malignancy detection via EBUS-TBNA. Integrating these parameters can optimize preoperative staging and ensure sufficient diagnostic evaluation for personalized treatment planning in thoracic oncology.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Optimal maximum standardized uptake value and nodal diameter cut-offs for predicting diagnostic sensitivity of endobronchial ultrasound-guided transbronchial needle aspiration

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月17日

查看全文
  • Yo Tsukamoto,
  • Saki Tsubouchi,
  • Lulu Li,
  • Maki Nakashima,
  • Takamasa Shibazaki,
  • Tomonari Kinoshita,
  • Takeo Nakada,
  • Takashi Ohtsuka

摘要

Background

This study aimed to identify clinical predictors of diagnostic sensitivity for malignancy in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and to determine optimal cut-off values for preoperative imaging parameters. We retrospectively reviewed 124 patients who underwent EBUS-TBNA for suspected thoracic malignancy between 2019 and 2022. Among 93 patients with available 18 F-fluorodeoxyglucose positron emission tomography/ computed tomography (FDG-PET/CT) and confirmed malignancy, the association between EBUS-TBNA diagnostic positivity and clinical factors, including CT nodal long-axis diameter and maximum standardized uptake value (SUVmax), was analyzed. Optimal cut-off values were determined using receiver operating characteristic (ROC) curve analysis.

Results

Of the 93 patients analyzed, 75 (80.6%) were diagnosed via EBUS-TBNA (EBUS-positive group), while 18 (19.4%) were false negatives (EBUS-false-negative group). Multivariable logistic regression analysis, treating parameters as continuous variables, identified both nodal size (odds ratio [OR]: 1.150; 95% confidence interval [CI]: 1.030–1.290; p = 0.016) and SUVmax (OR: 1.170; 95% CI: 1.020–1.330; p = 0.021) as significant independent predictors of EBUS-TBNA positivity. ROC analysis established optimal cut-offs of 21 mm for nodal size (AUC: 0.802) and 7.9 for SUVmax (AUC: 0.805). When both criteria (nodal size ≥ 21 mm and SUVmax ≥ 7.9) were met, the positive predictive value reached 95.7%, with a diagnostic accuracy of 64.5% and a negative predictive value of 34.0%.

Conclusions

The combination of high metabolic activity (SUVmax ≥ 7.9) and nodal size (≥ 21 mm) serves as a predictor of malignancy detection via EBUS-TBNA. Integrating these parameters can optimize preoperative staging and ensure sufficient diagnostic evaluation for personalized treatment planning in thoracic oncology.