Related Experiment Video
Updated: May 5, 2026
Use of Electromagnetic Navigational Transthoracic Needle Aspiration E-TTNA for Sampling of Lung Nodules
Published on: May 23, 2015
Combined transbronchial needle aspiration and (99m)Tc-2-methoxy-isobutyl-isonitrile single photon emission computed
Alfonso Fiorelli1, Pierfrancesco Rambaldi2, Giovanni Vicidomini1
1Unidad de Cirugía Torácica, Segunda Universidad de Nápoles, Nápoles, Italia.
Background:
To demonstrate the diagnostic accuracy of an integrated approach of blind trans-bronchial needle aspiration (TBNA) and (99m)Tc-2-methoxy-isobutyl-isonitrile single photon emission computed tomography ((99m)Tc-MIBI-SPECT) in diagnosing mediastinal lymph adenopathy.
Methods:
Sixty one consecutive patients with mediastinal lymph adenopathy undergoing both TBNA and (99m)Tc-MIBI-SPECT were prospectively enrolled. Mediastinoscopy was attended in case of negative TBNA.
Results:
Eighty three adenopathies were sampled (73 malignant and 10 benign). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of TBNA was 74%, 100%, 100%, and 34%, respectively; and of (99m)Tc-MIBI-SPECT was 96%, 80%, 97%, and 73%, respectively. Combining TBNA and (99m)Tc-MIBI-SPECT results sensitivity, specificity, PPV, NPV of 97%, 100%, 100%, and 83%, respectively, was obtained. TBNA alone avoided medistianoscopy in 65% of cases, while an integrated approach could have potentially obviated mediastinoscopy in 76%.
Conclusions:
(99m)Tc-MIBI-SPECT improved the sensitivity and the NPV of TBNA, reducing the need of mediastinoscopy.
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