Endobronchial Ultrasonography in the Assessment of Centrally Located Early-Stage Lung Cancer before Photodynamic Therapy

• Published in: American journal of respiratory and critical care medicine Vol. 165; no. 6; pp. 832 - 837
• Main Authors: MIYAZU, YUKA, MIYAZAWA, TERUOMI, KURIMOTO, NORIAKI, IWAMOTO, YASUO, KANOH, KOJI, KOHNO, NOBUOKI
• Format: Journal Article
• Language: English
• Published: New York, NY Am Thoracic Soc 15.03.2002; American Lung Association
• Subjects: Aged; Biological and medical sciences; Carcinoma in Situ - diagnostic imaging; Carcinoma in Situ - pathology; Carcinoma in Situ - therapy; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Endosonography; Female; Humans; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Male; Medical sciences; Middle Aged; Neoplasm Invasiveness; Patient Selection; Photochemotherapy; Pneumology; Prospective Studies; Tumors of the respiratory system and mediastinum; Sonography; Human; Lung disease; Carcinoma; Radiodiagnosis; Respiratory disease; Instrumentation therapy; Bronchus; Exploration; Early stage; Malignant tumor; Bronchopulmonary; Phototherapy; Treatment; Bronchus disease; Medical imagery; Computerized axial tomography; Ultrasonic transducer
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/ajrccm.165.6.2108092

To evaluate the utility of endobronchial ultrasonography (EBUS) in selecting appropriate candidates with centrally located early-stage lung cancer for photodynamic therapy (PDT) with curative intent, we performed EBUS before PDT in 18 biopsy-proven squamous cell carcinomas (including three carcinoma in situ) that had been considered to be appropriate candidates for PDT by conventional bronchoscopy and high-resolution computed tomography (HR-CT). Nine lesions were diagnosed as intracartilaginous by EBUS and subsequently PDT was performed. Long-term complete remission has been achieved in these patients with a median follow-up term after PDT of 32 months. The remaining nine lesions were diagnosed as extracartilaginous by EBUS and were considered candidates for other therapies such as surgical resection, chemotherapy, and radiotherapy, although two were invisible by HR-CT, three were superficial, and five were < or = 1 cm in diameter on observation by bronchoscopy. The depth of tumor invasion estimated by EBUS was proven to be accurate by histopathologic findings in six specimens after surgical resection. We conclude that EBUS is a useful technique that might be considered in addition to conventional bronchoscopy and HR-CT to improve the efficacy of PDT in patients with centrally located early-stage lung cancer.