Correlation between the probability of malignancy and maximum standard uptake values of mediastinal lymph nodes on 18F-FDG positron emission tomography scan sampled by endobronchial ultrasound-guidedtransbronchial needle aspiration: A retrospective analysis

Abstract

INTRODUCTION: Endobronchial ultrasound‑guided transbronchial needle aspiration (EBUS‑TBNA)is frequently used as an important initial investigation for diagnosing and staging for both suspectedmalignant and benign mediastinal lesions for the last 10 years.AIM: We aimed to analyze the correlation between probability of malignity by EBUS‑TBNA andmaximum standard uptake value (SUVmax) obtained by 18F‑labeled fluorodeoxyglucose positronemission tomography‑computed tomography (18F‑FDG PET CT).METHODS: This is a retrospective study using hospitals’ database records. Demographic featuresof the patients, characteristics of the biopsied lymph nodes (LNs), PET‑CT results, and SUVmax areobtained from hospital database system.RESULTS: A total of 322 patients underwent EBUS‑TBNA for a final diagnosis. The mean agewas 59.4 years. The most common final diagnosis was nonsmall cell lung cancer. When wecompared the average SUVmax, as the SUVmax increased, the probability of malignity increasedsignificantly (P < 0.001). We studied a Youden index for SUVmax and the cutoff point for SUVmax was9 for 54.39% sensitivity and 79.1% specificity.CONCLUSION: Our study in a real‑life setting showed that EBUS‑TBNA is effective in diagnosingpatients who had mediastinal LNs suspected of malignancy. We also showed that as the SUVmaxincreased, the probability of malignancy increased. We believe that more data are needed from alarger number of patients from different centers.