Systematic evaluation of the pulmonary arteries during endobronchial ultrasound (EBUS) in patients with suspected lung cancer a prospective cohort trial.

Background: Patients with lung cancer suffer from a severely increased risk of venous thromboembolic disease. As the central pulmonary arteries can be assessed during EBUS, routine evaluation may be a valuable screening tool for pulmonary embolisms (PE).Method: Patients undergoing EBUS at our department were included. All patients underwent a CT or PET-CT prior to EBUS. The left pulmonary artery was identified by ultrasound in the distal part of the left bronchus and the artery was scanned continuously till the pulmonary trunk by moving the probe clockwise. The procedure was repeated on the right side rotating the probe counterclockwise.Results: One-hundred patients were included (table 1). Median added scanning time was 2 min (Q1-Q3: 2-3, n=96). PE was found in two patients, both not discovered in prior scans. One patient was referred to a ventilation/perfusion scintigraphy which confirmed the PE. For the other patient, the PE was indirectly confirmed through presence of a deep venous thrombus. Both patients were diagnosed with lung cancer. Malignancy was diagnosed in 69 patients, of whom 59 had lung cancer with 27 patient in stage IV.Conclusion: Scanning the pulmonary arteries during EBUS is barely time consuming. PE was only found in 2% despite a large number of advanced lung cancers. Both PE’s were novel findings, highlighting the limitations of CT/PET-CT for PE. Whether an evaluation of the pulmonary arteries should be implemented in all procedures cannot be concluded. Our study, however, demonstrates the versatility of EBUS and the potential clinical impact if the pulmonologist is able to assess the pulmonary arteries.FootnotesCite this article as Eur Respir J 2022; 60: Suppl. 66, 1746.This article was presented at the 2022 ERS International Congress, in session “-”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).