Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS)

Vilmann, Peter; Clementsen, Paul Frost; Colella, Sara; Siemsen, Mette; Leyn, Paul De; Dumonceau, Jean‐Marc; Herth, Felix; Larghi, Alberto; Vasquez-Sequeiros, Enrique; Hassan, Cesare; Crombag, Laurence; Korevaar, Daniël A.; Konge, Lars; Annema, Jouke T.

doi:10.1055/s-0034-1392040

Cited by 227 publications

(191 citation statements)

References 84 publications

(116 reference statements)

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“…Application of EUS and EUS-FNA to the LAG was initially reported by Chang et al [9] in 1996. Nowadays, EUS with transgastric FNA is the procedure of choice when tissue confirmation of the LAG in lung cancer patients is indicated [18]. Sampling of the LAG using a conventional EUS scope can be combined with an EBUS scope in a single endoscopy session to ensure a complete endobronchial and esophageal mediastinal nodal staging procedure [18,26].…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, EUS with transgastric FNA is the procedure of choice when tissue confirmation of the LAG in lung cancer patients is indicated [18]. Sampling of the LAG using a conventional EUS scope can be combined with an EBUS scope in a single endoscopy session to ensure a complete endobronchial and esophageal mediastinal nodal staging procedure [18,26]. However, using both an EBUS (broncho)scope and an EUS endoscope necessitates the purchase and maintenance of expensive equipment and training in the use of different endoscopes.…”

Section: Discussionmentioning

confidence: 99%

“…The endoscopic procedures were performed in the Academic Medical Centre Amsterdam by 3 experienced chest physicians who are specifically trained in EBUS, EUS, and EUS-B for the diagnosis and staging of lung cancer, including LAG analysis. In our hospital, the combination of EBUS and EUS(-B) in lung cancer patients with an indication for mediastinal nodal staging is performed according to the guideline from June 2015 [18]. EUS(-B) is performed according to the EUS assessment tool (EUSAT) that includes systematic mediastinal nodal staging, including the identification of the liver, coeliac trunk, and the LAG [24].…”

Section: Methodsmentioning

confidence: 99%

“…By combining an endobronchial ultrasound (EBUS) with an EUS(-B) procedure, complete hilar and mediastinal staging can be achieved [18]. Increasing evidence shows that the combined endobronchial and esophageal staging can be performed using just the EBUS scope, introducing it into the esophagus following the endobronchial nodal assessment [19].…”

Section: Introductionmentioning

confidence: 99%

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Left Adrenal Gland Analysis in Lung Cancer Patients Using the Endobronchial Ultrasound Scope: A Feasibility Trial

Crombag

Annema²

2016

Respiration

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Background: In lung cancer patients, the adrenal glands are predilection sites for distant metastases. Esophageal endoscopic ultrasound - fine-needle aspiration (EUS-FNA) is a minimally invasive and accurate method for left adrenal gland (LAG) analysis but requires a conventional gastrointestinal echoendoscope. Complete endobronchial and esophageal mediastinal nodal staging can be achieved by just a single endobronchial ultrasound (EBUS) scope, introducing it into the esophagus (EUS-B) following the endobronchial procedure. Whether the LAG can also be assessed with the EBUS scope is unknown. Objectives: The aim of the study was to investigate the feasibility of identifying the LAG with the EBUS scope. Methods: We conducted a retrospective analysis of lung cancer patients who underwent EBUS and EUS-B for mediastinal staging and LAG assessment between January 2013 and May 2015. Results: A total of 143 patients with (suspected) lung cancer were investigated by the combination of EBUS and EUS-B. In 68 of the 80 patients (85%) in whom an attempt was made to identify the LAG, it was feasible to transgastrically detect the LAG with the EBUS scope. In 9 patients with endosonographic signs of malignant involvement, diagnostic transgastric FNAs were obtained in all. In the 12 patients (15%) in whom the LAG was not detected, the contact between the ultrasound transducer and the gastric wall was suboptimal - the length of the scope was not a limiting factor. Conclusions: The EBUS scope allows identification of the LAG in the vast majority of lung cancer patients. Implication: In patients with (suspected) lung cancer, in addition to complete hilar and mediastinal staging, LAG assessment using just a single EBUS scope also seems feasible. Prospective studies are indicated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Left Adrenal Gland Analysis in Lung Cancer Patients Using the Endobronchial Ultrasound Scope: A Feasibility Trial

Crombag

Annema²

2016

Respiration

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“…In recent years, chest physicians have started using an endoscope designed for endobronchial ultrasound (EBUS) in the esophagus (EUS-B) for detection and biopsy of lesions both above and below the diaphragm including the left adrenal gland [3,4,5]. However, EUS-B-FNA from a liver metastasis has never been described before.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Liver Biopsy in the Hands of a Chest Physician

Fally¹,

Nessar²,

Behrendt

et al. 2016

Respiration

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Liver biopsy using transesophageal bronchoscopic ultrasound-guided fine needle aspiration (EUS-B-FNA) has never been described before and biopsies of infradiaphragmatic lesions using this technique are not considered to be standard. A patient suspected for primary lung cancer with multiple lesions in the liver was referred to our department. We conducted bronchoscopy and endobronchial ultrasound-guided (EBUS) biopsy from several enlarged mediastinal lymph nodes. Thereafter, we conducted EUS-B-FNA from a lesion in the left liver lobe. Pathology showed that the liver lesion represented a metastasis from a pulmonary adenocarcinoma. Bronchoscopy and EBUS samples were not able to establish diagnosis. We hereby demonstrated that a diagnostic EUS-B-FNA from a liver metastasis in a patient with lung cancer is possible. This underlines that chest physicians should not forget the esophagus when staging lung cancer.

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The role of endobronchial ultrasound‐guided transbronchial needle aspiration liquid‐based cytology in the diagnosis of mediastinal lymphadenopathy

Qin

Lei

et al. 2019

Diagnostic Cytopathology

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Background Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is a minimally invasive, reliable technique for sampling mediastinal lymph nodes (LNs). Liquid‐based cytology (LBC) is widely used for cervical cancer screening because it provides reliable and feasible results. The present study aimed to evaluate effectiveness of the combination of EBUS‐TBNA and LBC in the diagnosis of mediastinal lymphadenopathy. Methods A total of 602 LNs that were retrospectively analyzed were sampled in 442 patients who underwent EBUS‐TBNA between January 2014 and December 2016. The histopathological result of TBNA tissue or cell blocks was considered as the gold standard to evaluate diagnostic utility of LBC and conventional smears (CS) for the diagnosis of mediastinal lymphadenopathy. Results Of the 602 LNs, 265 were mediastinal LN metastases from lung cancer, four were lymphoma, and 333 were benign. The sensitivity of LBC and CS in the diagnosis of mediastinal LN metastases from lung cancer was 72.8% and 63%, respectively, and the specificity was 98.5% and 97%, respectively. The positive predictive values for LBC and CS were 97.5% and 94.4%, respectively, whereas the negative predictive values were 82.2% and 76.9%, respectively. The accuracy of LBC and CS was 88% and 83.7%, respectively. The diagnostic value of LBC was significantly higher than that of CS (P = .001). Conclusions The combination of EBUS‐TBNA and LBC is a highly reliable and feasible procedure that optimizes diagnostic utility for the diagnosis of lung cancer and mediastinal LN staging.

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Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS)

Cited by 227 publications

References 84 publications

Left Adrenal Gland Analysis in Lung Cancer Patients Using the Endobronchial Ultrasound Scope: A Feasibility Trial

Left Adrenal Gland Analysis in Lung Cancer Patients Using the Endobronchial Ultrasound Scope: A Feasibility Trial

Endoscopic Ultrasound-Guided Liver Biopsy in the Hands of a Chest Physician

The role of endobronchial ultrasound‐guided transbronchial needle aspiration liquid‐based cytology in the diagnosis of mediastinal lymphadenopathy

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