Universidad del Desarrollo

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Additive Value of EBUS-TBNA for Staging Non-Small Cell Lung Cancer in Patients Evaluated for Stereotactic Body Radiation Therapy
(MDPI AG, 2025-08-24)
Joshua M. Boster
;
S. Michael Goertzen
;
Paula V. Sainz
;
Rodríguez Vial, Macarena
;
Jhankruti K. Zaveri-Desai
Background/Objectives: Patients with non-small cell lung cancer (NSCLC) being evaluated for stereotactic body radiation therapy (SBRT) are frequently staged non-invasively with positron emission tomography/computed tomography (PET/CT). Performing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in addition to PET/CT scanning may increase clinical certainty in lymph node staging, but the magnitude of added benefit of EBUS-TBNA over non-invasive staging methods is unclear. Methods: A single-center prospective cohort study involving patients with suspected or confirmed Stage I or IIa NSCLC referred for EBUS-TBNA prior to SBRT was performed. The primary outcome was concordance between PET/CT and EBUS-TBNA for nodal metastases. Secondary endpoints included sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PET/CT, and clinical outcomes based on staging results. Results: Among 115 patients, the concordance between PET/CT and EBUS-TBNA was 84.3% (95% CI: 0.76 0.90). EBUS-TBNA led to a stage shift in 15.7% of cases: 4 of 98 PET/CT N0 patients (4.1%) had nodal metastases, while 14 of 17 PET/CT N1 patients (82.4%) were downstaged to N0. PET/CT sensitivity was 42.9% (95% CI: 0.09–0.81), specificity 87% (95% CI: 0.79–0.93), PPV 17.6% (95% CI: 0.04–0.43), and NPV 95.9% (95% CI: 0.90–0.99). PET/CT-positive, EBUS-TBNA-negative patients had worse survival (HR 4.25, 95% CI: 1.24–14.53, p = 0.021) compared with double-negative patients. Conclusions: EBUS-TBNA improves staging accuracy over PET/CT in early-stage NSCLC, impacting SBRT candidacy. However, PET/CT-positive, EBUS-TBNA-negative patients had worse outcomes in comparison to double-negative patients, suggesting a need for additional therapy or surveillance in that population.</jats:p>
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Endobronchial ultrasound- guided transbronchial needle aspiration for mediastinal lymph node staging in patients with typical pulmonary carcinoids
(2020)
Macarena R. Vial
;
Faria Nasim
;
Henriette De La Garza
;
David E. Ost
;
Roberto F. Casal
12Scopus© Citations 4
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Primary Tracheal Carcinoma
(2018)
Farah Kazzaz
;
Oisin O’Connell
;
MACARENA RODRIGUEZ VIAL
;
Horiana B. Grosu
12Scopus© Citations 5
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Needle Fracture during Endobronchial Ultrasound–guided Transbronchial Needle Aspiration
(2016)
MACARENA RODRIGUEZ VIAL
;
John O. O’Connell
;
Horiana B. Grosu
;
David E. Ost
;
George A. Eapen
2Scopus© Citations 17
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Pleural Fluid Cytokine Levels at Baseline and Over Time are Associated With Time to IPC Removal
(2020)
Horiana B. Grosu
;
Wei Lu
;
David E. Ost
;
Macarena R. Vial
;
Mike Hernandez
11Scopus© Citations 6
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Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Nodal Staging of Stereotactic Ablative Body Radiotherapy Patients
(2017)
MACARENA RODRIGUEZ VIAL
;
Kashif A. Khan
;
Oisin O’Connell
;
S. Andrew Peng
;
Daniel R. Gomez
5Scopus© Citations 40
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What Exactly Is a Centrally Located Lung Tumor? Results of an Online Survey
(2017)
Roberto F. Casal
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MACARENA RODRIGUEZ VIAL
;
Russell Miller
;
Lakshmi Mudambi
;
Horiana B. Grosu
1Scopus© Citations 55
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Radiation-induced Angiosarcoma as a Cause of Pleural Effusion.
(2017)
Russell Miller
;
Lakshmi Mudambi
;
MACARENA RODRIGUEZ VIAL
;
Neda Kalhor
;
Horiana B. Grosu
Scopus© Citations 8 3
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Pleural Touch Preparations and Direct Visualization of the Pleura during Medical Thoracoscopy for the Diagnosis of Malignancy
(2017)
Horiana B. Grosu
;
MACARENA RODRIGUEZ VIAL
;
Erik Vakil
;
Roberto F. Casal
;
George A. Eapen
Scopus© Citations 5 1
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Diagnostic performance of endobronchial ultrasound-guided mediastinal lymph node sampling in early stage non-small cell lung cancer: A prospective study
(2018)
MACARENA RODRIGUEZ VIAL
;
Oisin J. O'Connell
;
Horiana B. Grosu
;
Mike Hernandez
;
Laila Noor
Scopus© Citations 56 1

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