Comparison of 21-Gauge and 22-Gauge Aspiration Needle in Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Abstract

Lung cancer is the third most commonly diagnosed cancer and accounts for the greatest number of cancer-related deaths in the United States. 1 The majority of patients with lung cancer present with advanced stage disease and will not benefi t from surgical resection. It is imperative to obtain mediastinal lymphatic tissue sampling in order to stage the mediastinum to prevent patients with advanced disease Results: A total of 1,235 patients met inclusion criteria. Sample adequacy was obtained in 94.9% of the 22G needle group and in 94.6% of the 21G needle group ( P 5 .81). A diagnosis was made in 51.4% of the 22G and 51.3% of the 21G groups ( P 5 .98). Multivariate hierarchical logistic regression showed no statistical difference in sample adequacy or diagnostic yield between the two groups. The presence of rapid onsite cytologic evaluation was associated with signifi cantly fewer needle passes per procedure when using the 21G needle ( P , .001). Conclusions: There is no difference in specimen adequacy or diagnostic yield between the 21G and 22G needle groups. EBUS-TBNA in conjunction with rapid onsite cytologic evaluation and a 21G needle is associated with fewer needle passes compared with a 22G needle.

Guideline for the Acquisition and Preparation of Conventional and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Specimens for the Diagnosis and Molecular Testing of Patients with Known or Suspected Lung Cancer

“…Two retrospective studies [11,12] had similar results, also failing to find a difference in the overall diagnostic yield between EBUS-TBNA using 22- and 21-gauge needles. The study by Yarmus et al [11] analyzed data from the AQuIRE (American College of Chest Physicians Quality Improvement Registry, Evaluation and Education) Data Registry with multicenter contributions; 249 procedures were performed with 21-gauge needles, and 995 were performed with 22-gauge needles.…”

“…The study by Yarmus et al [11] analyzed data from the AQuIRE (American College of Chest Physicians Quality Improvement Registry, Evaluation and Education) Data Registry with multicenter contributions; 249 procedures were performed with 21-gauge needles, and 995 were performed with 22-gauge needles. No differences in either sample adequacy (per LN analysis) or diagnostic yield (both per patient and per LN analysis) were found.…”

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Pilot Study to Evaluate the Utility of the ProCore Biopsy Needle for Lymph Node Sampling

“…The impact of aspiration needles on specimen adequacy or diagnostic yield during EBUS-TBNA has not been well studied and the findings are controversial. Yarmus et al [9] evaluated the diagnostic yield of the needle gauge in 1,299 patients who underwent EBUS-TBNA. Their work revealed no difference in specimen adequacy or diagnostic yield by using different needle gauges (21 vs. 22 G).…”

The use of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in a pediatric population: A multicenter study

“…In one of the largest EBUS‐TBNA studies reported to date, sample adequacy was 90% and diagnostic yield ranged from 37% to 54% depending on hospital volume . While not as well studied in pediatrics, EBUS‐TBNA has become well accepted for the evaluation of lymphadenopathy unrelated to primary lung cancer, such as lymphoma and sarcoidosis …”