A Practical Algorithmic Approach to the Diagnosis and Management of Solitary Pulmonary Nodules

Patel, Vishal; Naik, Sagar; Naidich, David P.; Travis, William D.; Weingarten, Jeremy A.; Lazzaro, Richard; Gutterman, David D.; Wentowski, Catherine; Grosu, Horiana B.; Raoof, Suhail

doi:10.1378/chest.12-0960

Cited by 141 publications

(133 citation statements)

References 118 publications

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“…With the established role of low-dose helical computed tomography (CT) screening for lung cancer (1,2) and the wide application of high-resolution CT (HRCT), pulmonary lesions are increasingly detected (3). Peripheral pulmonary lesions (PPLs) are a common problem in pulmonary practice.…”

Section: Introductionmentioning

confidence: 99%

Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: a systematic review and meta-analysis

Zhan¹,

Zhu²,

Miu³

et al. 2017

Transl. Lung Cancer Res.

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Background: With the release of the National Lung Screening Trial results, the detection of peripheral pulmonary lesions (PPLs) is likely to increase. Computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and radial probe endobronchial ultrasound (r-EBUS)-guided transbronchial lung biopsy (TBLB) are recommended for tissue diagnosis of PPLs.Methods: A systematic review of published literature evaluating the accuracy of r-EBUS-TBLB and CT-PTNB for the diagnosis of PPLs was performed to determine point sensitivity and specificity, and to construct a summary receiver-operating characteristic curve.Results: This review included 31 publications dealing with EBUS-TBLB and 14 publications dealing with CT-PTNB for the diagnosis of PPLs. EBUS-TBLB had point sensitivity of 0.69 (95% CI: 0.67-0.71) for the diagnosis of peripheral lung cancer (PLC), which was lower than the sensitivity of CT-PTNB (0.94, 95% CI: 0.94-0.95). However, the complication rates observed with EBUS-TBLB were lower than those reported for CT-PTNB.Conclusions: This meta-analysis showed that EBUS-TBLB is a safe and relatively accurate tool in the investigation of PLC. Although the yield remains lower than that of CT-PTNB, the procedural risks are lower.Keywords: Computed tomography-guided percutaneous transthoracic needle biopsy (CT-PTNB); radial probe endobronchial ultrasound-guided transbronchial lung biopsy (r-EBUS-TBLB); peripheral pulmonary lesions; diagnosis; meta-analysis

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Section: Introductionmentioning

confidence: 99%

Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: a systematic review and meta-analysis

Zhan¹,

Zhu²,

Miu³

et al. 2017

Transl. Lung Cancer Res.

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“…Tüm akciğer grafilerinin %0,09-7'sinde SPN'ye rastlanmaktadır. 2,10,11 Akciğer kanseri nedeni ile yapılan BT taramalarında %8-51 oranında saptanmıştır. 4 SPN saptandığında en az invaziv yöntemle benign-malign ayrımı yapıl-maya çalışılmalıdır.…”

Section: Discussionunclassified

“…SPN'de etiyolojik spektrum hamartom gibi benign patolojilerden, ölümcül olabilen akciğer kanserine kadar geniş bir patoloji grubunu içermektedir. [1][2][3][4]6,10,11 Her ne kadar pulmoner nodül-lerin çoğu benign olsa da kanser tanısını dışlamak iki-üç yıllık bir zaman gerektirebilmektedir. Çalış-malarda, 50 yaş üstünde sigara içen ve nodül izlemi olan hastalarda çalışmamızla paralel olarak %1-1,5 oranında kanser gelişmektedir.…”

Section: Discussionunclassified

Changes in Smoking Behavior of Patients with Pulmonary Nodule Follow-up

Üzer¹,

Özbudak²

2017

Turkiye Klinikleri Arch Lung

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“…By incorporating imaging features, such as size and solidity of the nodules, and clinical and social data such as smoking history, a comprehensive algorithm was developed to stratify patients in the diagnosis and management of solitary pulmonary nodules. 12 This has led to a more streamlined diagnostic and management pathway, thus reducing unnecessary investigations.…”

Section: Improved Data Analysismentioning

confidence: 99%

Picture the future: emerging imaging modalities

Lee

Gleeson

2014

Clinical Medicine

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The past century has witnessed accelerated development in imaging modalities. Better anatomical visualisation and improved data analysis have improved survival rates. Through emerging functional, molecular and structural imaging modalities, better anatomical visualisation has been extended to cellular and molecular detail, improving diagnosis and management of diseases. This article reviews the advances made in emerging imaging modalities as well as their potential applications in targeted therapy.

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A Practical Algorithmic Approach to the Diagnosis and Management of Solitary Pulmonary Nodules

Cited by 141 publications

References 118 publications

Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: a systematic review and meta-analysis

Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: a systematic review and meta-analysis

Changes in Smoking Behavior of Patients with Pulmonary Nodule Follow-up

Picture the future: emerging imaging modalities

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