1. Pulmonary Department, “Bioclinic” Private Hospital, Thessaloniki, Greece.
2. 3 rd University General Hospital, “AHEPA” University Hospital, Thessaloniki, Greece.
3. Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
4. Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece.
5. Thoracic Surgery Department, “Interbalkan” European Medical Center, Thessaloniki, Greece.
6. Oncology Department, General Hospital of Rhodos, Rhodos, Greece.
7. Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, “Hof” Clinics, University of Erlangen, Hof, Germany.
8. Private Oncology Cabinet, Ioannina, Greece.
9. Oncology Department, “Bioclinic” Private Hospital, Thessaloniki, Greece.
10. Radiology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
11. Surgery Department, “General Clinic Euromedica” Private Clinic, Thessaloniki, Greece.
12. Ear, Nose and Throat (ENT) Department, Ludwig-Maximilians University of Munich, Munich, Germany.
13. Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
*These authors contributed equally.
Introduction: Lung lesions and undiagnosed mesothorax lymphadenopathy is an issue that several doctors face in the everyday clinical practice. PET-CT and CT of the thorax are usually the first examinations to identify characteristics of the lesions before biopsy.
Patients and Methods: We performed a retrospective study with 450 patients that had EBUS-TBNA with 22G, Upgraded 22G and 19G needles with and without PET-CT in order to identify the cost effeteness of performing EBUS-TBNA before or after PET-CT. All centers used the same PET-CT equipment and EBUS-TBNA system. Three types of needle were used for the endoscopy in order to identify similarities and differences for the cost-effectiveness. The costs in every center for every examination and materials were the same.
Results: There were more block slices for 19G>22Gupgraded>21G>22G and there was cost-effectiveness when in general PET-CT was performed prior to biopsy of any lesion. 19G needle was more effective for lymphomas, while 22Gupgraded and 21G needles were more cost-effective when used for smaller lesions for primary lung cancer of metastatic disease.
Conclusions: We have been using PET-CT and EBUS-TBNA in the everyday clinical practice according to the current guidelines for initial disease staging and re-staging. However; we can also use both in a cost effective method based on the initial radiologic findings.
Keywords: EBUS-TBNA, lung cancer, lymphoma, 22G needle, 19G needle, CT, PET-CT, Mesothorax