The Diagnostic Accuracy and Sensitivity for Malignancy of Radial-Endobronchial Ultrasound and Electromagnetic Navigation Bronchoscopy for Sampling of Peripheral Pulmonary Lesions: Systematic Review and Meta-analysis.
J Bronchology Interv Pulmonol
; 27(2): 106-121, 2020 Apr.
Article
in En
| MEDLINE
| ID: mdl-31985505
ABSTRACT
BACKGROUND:
Lung cancer screening with computed tomography chest is identifying peripheral pulmonary lesions (PPLs) suspicious for early-stage lung cancer at increasing rates. Radial-endobronchial ultrasound (R-EBUS) and electromagnetic navigation bronchoscopy (ENB) are 2 methods to sample PPLs to diagnose and treat early lung cancer. ENB has a higher operating financial cost, however, the rationale for its use is possible higher diagnostic accuracy versus R-EBUS.OBJECTIVE:
The objective of this study was to determine the comparative diagnostic accuracy, sensitivity, and negative predictive value for R-EBUS and ENB in sampling PPLs.METHODS:
A systematic review and meta-analysis were conducted. The Ovid Medline database was queried for original research reporting a diagnostic yield of R-EBUS or ENB for PPLs identified on computed tomography chest suspicious for malignancy. The I statistic assessed study heterogeneity. Random effects models produced pooled estimates of diagnostic accuracy and sensitivity for malignancy. Reasons for heterogeneity were explored with meta-regression. Publication bias and small study effects were assessed.RESULTS:
A total of 41 studies involved 2988 lung nodules (R-EBUS 2102, ENB 886) in 3204 patients (R-EBUS 2097, ENB 1107). Overall sensitivity to detect cancer was 70.7% [95% confidence interval (CI) 67.2-74.0]; R-EBUS 70.5% (95% CI 66.1-74.8), ENB 70.7% (95% CI 64.7-76.8). Pooled overall diagnostic accuracy was 74.2% (95% CI 71.0-77.3); R-EBUS 72.4% (95% CI 68.7-76.1), ENB 76.4% (95% CI 70.8-82.0). The localization modalities had comparative safety profiles of <2% complications.CONCLUSION:
Both technologies have a high proportion of successful PPL localization with similar sensitivity for malignancy and accuracy. As such, both reasonable options for health care authorities to employ diagnostic algorithms.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Specimen Handling
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Bronchoscopy
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Endosonography
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Lung Neoplasms
Type of study:
Diagnostic_studies
/
Prognostic_studies
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Screening_studies
/
Systematic_reviews
Limits:
Aged
/
Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
J Bronchology Interv Pulmonol
Year:
2020
Document type:
Article