Endobronchial Ultrasound Transbronchial Needle Aspiration in Thoracic Diseases: Much More than Mediastinal Staging

Guarize, Juliana; Casiraghi, Monica; Donghi, Stefano; Diotti, Cristina; Vanoni, Nicolò; Romano, Rosalia; Casadio, Chiara; Brambilla, Daniela; Maisonneuve, Patrick; Petrella, Francesco

doi:10.1155/2018/4269798

Cited by 30 publications

(31 citation statements)

References 23 publications

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“…Disease-specific accuracy was 81.7%, 84% and 78.9% in the diagnosis of cancer, NSCLC and non-cancer lesions, respectively. The accuracy achieved was largely comparable with those reported in literature (14)(15)(16)(17). The sensitivities for all pathologies, cancer, NSCLC and non-cancer were 55.1, 48.8, 48.3, and 60%, respectively.…”

Section: Discussionsupporting

confidence: 86%

Diagnostic Accuracy of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) in Real Life

et al. 2020

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Background: EBUS-TBNA is an integral tool in the diagnosis and staging of lung cancer and other diseases involving mediastinal lymphadenopathy. Most studies attesting to the performance of EBUS-TBNA are prospective analyses performed under strict protocols. The objective of our study was to compare the accuracy of EBUS-TBNA to surgery in diagnosing hilar and mediastinal pathologies in a tertiary hospital, staffed by pulmonologists with and without formal interventional pulmonary training. Methods: We retrospectively analyzed subjects who underwent EBUS-TBNA followed by a confirmatory surgical procedure from January 2012 to December 2018. The primary outcome was to evaluate the accuracy of EBUS-TBNA in the diagnosis of all mediastinal disease. Secondary analyses determined the accuracy of EBUS-TBNA in cancer, NSCLC, and non-malignant lesions individually. Results: One hundred and forty-three subjects had an EBUS-TBNA procedure followed by surgery. EBUS-TBNA for all pathologies had an accuracy of 81.2% (CI 95% 73.8-87.4) and sensitivity of 55.1% (CI 95% 41.5-68.3). The accuracy and sensitivity of individual groups were: cancer (81.7, 48.8%), NSCLC (84, 48.3%), and non-malignancy (78.9, 60%). The NSCLC group had 15 false negatives and 5 (33.3%) of them were due to non-sampling of EBUS accessible nodes. Missed sampling led to a change in the final staging in 8.6% of NSCLC subjects. Conclusion: The accuracy of EBUS-TBNA across all groups was comparable to those reported previously. However, the sensitivity was comparatively lower. This was primarily due to the large number of EBUS-TBNA accessible lymph nodes that were not sampled. This data highlights the need for guidelines outlining the best sampling approach and lymph node selection.

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Section: Discussionsupporting

confidence: 86%

Diagnostic Accuracy of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) in Real Life

et al. 2020

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“…In this prospective study, we analysed the first 266 unselected consecutive patients who underwent thoracic endosonography in our centre in a 4‐year study period. Our study showed an overall diagnostic yield of 68.4%, which were in line with previously published evidence reporting a yield between 61% and 92% 4,5,11,34 . A possible explanation that our yield reached the lower end of this range is the study design that included an unselected study population in a real‐world setting.…”

Section: Discussionsupporting

confidence: 91%

Thoracic endosonography (EBUS/EUS‐b) in the diagnosis of different intrathoracic diseases: A 4‐year experience at a single‐centre in Greece

et al. 2020

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Background In the last decade, the advent of thoracic endosonography has revolutionised the field of diagnostic bronchoscopy. Methods We conducted a single‐centre prospective study in “Sotiria” Chest diseases hospital between January 2016 and December 2019. The study aimed to evaluate the efficacy and diagnostic value of combined EBUS/EUS‐b in comparison with EBUS‐TBNA and EUS‐b FNA in different intrathoracic diseases. Results A total of 266 patients were enrolled (70.7% males, 85.7% smokers, mean age ± SD: 62.8 ± 11.8). Diagnosis and staging of suspected lung cancer (LC) were the main indications for EBUS/EUS‐b in 56.7% of patients, followed by lymphadenopathy of unknown origin in 27%, lymphadenopathy in previous malignancy in 10.9%, and staging of proven LC in 5.3%. EUS‐b FNA alone or combined with EBUS‐TBNA was performed in 14.7% of patients. A total of 512 lymph nodes was sampled (481 through EBUS‐TBNA and 31 through EUS‐b FNA). EBUS/EUS‐b led to a definitive diagnosis in 68.4% of the patients. Most cases (50.4%) were malignancies, while 18% represented benign diseases (83.3% sarcoidosis). Sensitivity of combined EBUS/EUS‐b was higher in comparison with sensitivity of both procedures alone (100% vs 89.4% vs 88.9%). Accordingly, the overall sensitivity of EBUS/EUS‐b for the detection of malignancy and sarcoidosis was 93% and 95.2%, respectively. No severe complications were observed. Conclusion Thoracic endosonography is an efficient, safe, minimally invasive tool yielding high sensitivity and diagnostic accuracy in patients with suspected malignancy and mediastinal lymphadenopathy. Experienced pulmonologists in EBUS‐TBNA should more routinely perform EUS‐b FNA to avoid unnecessary surgical interventions.

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“…The searches identified 5,675 results. After screening titles and abstracts, 191 potentially eligible articles remained, of which 14 studies were included in the final analysis [9,[14][15][16][17][18][19][20][21][22][23][24][25][26]. Of these, 3 were conference abstracts.…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

Endobronchial Ultrasound for the Diagnosis of Centrally Located Lung Tumors: A Systematic Review and Meta-Analysis

et al. 2019

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Introduction: Obtaining a tissue diagnosis of centrally located lung tumors in patients presenting without endobronchial abnormalities is challenging, and therefore a considerable diagnostic problem. Objective: The objective of this study was to evaluate the performance of linear endobronchial ultrasound guided-transbronchial-needle aspiration (EBUS-TBNA) for the diagnosis of centrally located lung tumors. Methods: We performed a systematic review (PROS-PERO, CRD42017080968) and searched MEDLINE, Embase, BIOSIS Previews, and Web of Science till November 18, 2018 for studies that evaluated the yield and/or sensitivity of EBUS-TBNA for diagnosing centrally located lung tumors. We assessed the study quality using QUADAS-2 and performed random-effects meta-analysis. Results: A total of 5,657 manuscripts were identified; of these 14 were considered for the study, including 1,175 patients who underwent EBUS-TBNA for diagnosing an intrapulmonary tumor. All studies had a high risk of bias or applicability concerns, predominately regarding patient selection. The average yield of EBUS-TBNA for diagnosing centrally located lung tumors was 0.89 (95% CI 0.84-0.92) and average sensitivity for diagnosing malignant tumors was 0.91 (95% CI 0.88-0.94). Among studies reporting this information, EBUS-related complications occurred in 5.4% of patients (42/721). Conclusion: EBUS-TBNA has a high yield and sensitivity for diagnosing centrally located lung tumors and is safe in selected patients. Prospective studies are recommended to evaluate the routine use of this procedure for diagnosing intrapulmonary tumors.

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Endobronchial Ultrasound Transbronchial Needle Aspiration in Thoracic Diseases: Much More than Mediastinal Staging

Cited by 30 publications

References 23 publications

Diagnostic Accuracy of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) in Real Life

Diagnostic Accuracy of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) in Real Life

Thoracic endosonography (EBUS/EUS‐b) in the diagnosis of different intrathoracic diseases: A 4‐year experience at a single‐centre in Greece

Endobronchial Ultrasound for the Diagnosis of Centrally Located Lung Tumors: A Systematic Review and Meta-Analysis

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