Jenson Phung, MD1, Taylor Bowler, DO2, Amir Sultan Seid, MD1, Natalie Wilson, MD1, Ryn Gagen, 1, Rahul Karna, MD2, Mohammad Bilal, MD3 1University of Minnesota, Minneapolis, MN; 2University of Minnesota Medical Center, Minneapolis, MN; 3University of Minnesota and Minneapolis VA Health Care System, Minneapolis, MN
Introduction: Endoscopic ultrasound (EUS) guided sampling of lung masses is emerging as an alternative to endobronchial or computed tomography guided approaches in select cases. Evaluation of EUS-guided fine needle aspiration (FNA) and fine needle biopsy (FNB) in the lung has only been reported in a limited number of studies, with rare reports of EUS-FNB. We aim to conduct a systematic review and meta-analysis to assess the efficacy and safety of EUS-FNA and EUS-FNB for lung mass sampling.
Methods: We conducted a literature search of multiple electronic databases (inception-May 2024). Studies were then screened and reviewed. Studies reporting EUS guided FNA and FNB of lung masses were included. Studies were excluded if they only involved sampling of mediastinum and lymph nodes, or if they were comprised of fewer than 5 patients. Diagnostic performance of EUS guided sampling was the primary outcome while secondary outcomes included technical success, specimen adequacy, and adverse event (AE) rate.
Results: Out of 3780 citations, 17 studies including 443 patients were analyzed. Thirteen studies assessed EUS-FNA, 2 studies assessed EUS-FNB, and 1 study included both FNA and FNB. Baseline and procedural characteristics are displayed in Table 1. Analysis of the diagnostic performance of EUS guided sampling revealed: sensitivity of 96% (95% CI [93-99%], I2: 25.24%) and diagnostic accuracy of 96% (95% CI [93-98%], I2: 24.07%). Specificity was 100% as reported across 5 studies. Overall technical success of the procedures was 98% (95% CI [96-100%], I2: 0%), specimen adequacy was 97% (95% CI [95-99%], I2: 0%), and AE rate was 2% (95% CI [1-4%], I2: 0%). Pneumothorax was seen in 2 cases with EUS-FNA. Other AEs included bleeding and aspiration pneumonia.
Discussion: Our review shows that EUS-guided sampling using both FNA and FNB is effective for diagnosing lung masses, with very high diagnostic accuracy and an acceptable safety profile. Future studies comparing the efficacy and safety of EUS-FNA and EUS-FNB for lung sampling are needed.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Jenson Phung indicated no relevant financial relationships.
Taylor Bowler indicated no relevant financial relationships.
Amir Sultan Seid indicated no relevant financial relationships.
Natalie Wilson indicated no relevant financial relationships.
Ryn Gagen indicated no relevant financial relationships.
Rahul Karna indicated no relevant financial relationships.
Mohammad Bilal: Boston Scientific – Consultant. Cook endoscopy – Speakers Bureau.
Jenson Phung, MD1, Taylor Bowler, DO2, Amir Sultan Seid, MD1, Natalie Wilson, MD1, Ryn Gagen, 1, Rahul Karna, MD2, Mohammad Bilal, MD3. P4476 - Endoscopic Ultrasound-Guided Sampling of Lung Masses: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
