Endobronchial ultrasound guided Echo Tip Ultra HD 22G needle versus Echo Tip Pro Core HD 22G needle in diagnosis of mediastinal lesions

Abstract

Background: Convex probe endobronchial ultrasound is a minimally invasive technique used for performing realtime transbronchial needle aspiration of enlarged hilar and mediastinal lymph nodes and could be used for diagnosing proximal peribronchial lesions. Although computed tomography, magnetic resonant imaging, and positron emission tomography/computed tomography have relatively high sensitivity for mediastinal evaluation, pathology is the gold standard. This study compared between Echo Tip Ultra HD-EBUS 22G needle and Echo Tip ProCore HD-EBUS 22G needle in diagnosis of mediastinal lesions using convex probe endobronchial ultrasound. Results: Twenty-four patients with mediastinal lesions were included. Convex probe endobronchial ultrasoundguided transbronchial needle aspiration using both Echo Tip Ultra HD 22G and Echo Tip ProCore HD 22G needles was done to all patients with no peripheral lymph node enlargement. CP-EBUS TBNA had diagnostic accuracy 50%, sensitivity 47.6%, and specificity 100% in diagnosis of mediastinal lesions. The Echo Tip Ultra HD needle had diagnostic accuracy 40.9%, sensitivity 38%, and specificity 100% compared to the Echo Tip ProCore HD needle which had diagnostic accuracy 31.8%, sensitivity 82.5%, and specificity 100%. The difference between both needles was statistically insignificant. The Echo Tip Ultra 22G HD needle had more representative cellularity (82%) compared to the Echo Tip ProCore 22G HD needle (45%) with a significant difference between both needles (p value = 0.001). Conclusion: Both needles can be used equally in sampling mediastinal lesions. This study supports that Echo Tip Ultra HD and Echo Tip ProCore HD needles can be used equally in sampling of mediastinal lesions and supports ultrasound screening of enlarged supraclavicular and cervical lymph nodes before performing EBUS-TBNA in patients with mediastinal lesions.