Radial EBUS versus CT-guided needle biopsy for evaluation of solitary pulmonary nodules

Wang, Wei; Yu, Li; Wang, Yuchao; Zhang, Qian; Chi, Chuanzhen; Zhan, Ping; Xu, Chunhua

doi:10.18632/oncotarget.23952

Cited by 34 publications

(43 citation statements)

References 25 publications

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“…While the CT‐TTNB approach achieved exhibited diagnostic performance when evaluating PPLs, the EBUS‐TBB approach was associated with lower complication rates. Indeed, lower complication rates were associated with the EBUS‐TBB approach in all included studies 10,13‐20 . CT‐TTNB was commonly associated with complications including pneumothorax and hemorrhage.…”

Section: Discussionmentioning

confidence: 86%

Endobronchial ultrasound‐guided versus computed tomography‐guided biopsy for peripheral pulmonary lesions: A meta‐analysis

Zhang

Wang

et al. 2020

Clinical Respiratory J

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Background Both endobronchial ultrasound‐guided transbronchial biopsy (EBUS‐TBB) and computed tomography‐guided transthoracic needle biopsy (CT‐TTNB) are approaches commonly utilized to diagnose peripheral pulmonary lesions (PPLs). The present meta‐analysis was, therefore, designed to provide more reliable evidence regarding the relative advantages of these two approaches to PPL diagnosis in order to guide clinical decision making. Methods The PubMed, Embase, and Cochrane Library databases were searched for relevant studies published as of May 2020. Endpoint data pertaining to technical success rates, diagnostic accuracy, and complication rates were then extracted from these studies. Meta‐analyses were conducted using RevMan v5.3. Results We identified nine total relevant studies for inclusion in the present meta‐analysis, incorporating 2025 total patients (2035 total procedures) that underwent EBUS‐TBB (n = 994) or CT‐TTNB (n = 1041) for the purposes of PPL diagnosis. Rates of technical success were comparable between these two groups (odds ratio [OR]: 0.16; P = 0.21). However, CT‐TTNB was associated with higher diagnostic yield (OR: 0.23; P < 0.00001), greater accuracy (OR: 0.43; P = 0.002), and higher rates of complications (OR: 7.27; P < 0.00001) than was EBUS‐TBB. Subgroup analyses revealed that CT‐TTNB was associated with better diagnostic yield and accuracy when analyzing small lesions and lesions that were proximal to the pleura. Significant heterogeneity among studies was detected with respect to both technical success rates and diagnostic yield, but there was no evidence of publication bias. Conclusions When diagnosing PPLs, CT‐TTNB is associated with higher diagnostic yield and accuracy but with poorer safety outcomes than EBUS‐TBB.

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Section: Discussionmentioning

confidence: 86%

Endobronchial ultrasound‐guided versus computed tomography‐guided biopsy for peripheral pulmonary lesions: A meta‐analysis

Zhang

Wang

et al. 2020

Clinical Respiratory J

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“…Lesions concerning the digestive tract and the tracheobronchial tree are almost exclusively biopsied using endoscopic procedures. Deep mediastinal tumors and large pulmonary tumors located close to large bronchi are more readily accessible for endobronchial ultrasound (EBUS) guided biopsies [5, 6]. The possibility of ultrasound guidance should be excluded first for all other tumors or fluid collections, irrespective of their location.…”

Section: Discussionmentioning

confidence: 99%

“…The biopsy of pulmonary tumors is one of the most frequent CT-guided procedures. According to a recent prospective randomized study that compared the diagnostic accuracy between CT-guided and EBUS-guided biopsies the results were significantly in favor of CT guidance with rates of 85% and 65%, respectively[5]. In the case of centrally located, large tumors, the accuracy of EBUS nears that of CT, being a viable alternative, especially because of its lower risk of pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

“…In the case of centrally located, large tumors, the accuracy of EBUS nears that of CT, being a viable alternative, especially because of its lower risk of pneumothorax. CT guidance, however, offers significantly greater precision for smaller, more peripheral located tumors [5,12]. Performed by an experienced radiologist, biopsies of very small tumors can have satisfactory success rates as shown by Chang et al who reported a diagnostic accuracy of 87.1% for tumors <8 mm [12].…”

Section: Discussionmentioning

confidence: 99%

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CT-guided procedures: an initial experience

Roman

Achimaș-Cădariu

Fetică

et al. 2018

Medicine and Pharmacy Reports

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Background and aimsDespite their usefulness, CT-guided procedures have a low profile in Romania. The current study has the purpose of describing a first experience in performing these procedures.MethodsTumors and fluid collections that were inaccessible for biopsy or drainage by ultrasound or endoscopic guidance were included. The procedures were performed using a 64-slice GE Optima CT660 CT scanner. The biopsies were carried out using the coaxial technique with an 18 G semiautomatic needle. The drainages were performed using 10 F pig-tail drains that were inserted using the Seldinger technique. Data regarding the size and location of the target lesion, puncture technique, success and complication rates were recorded.ResultsBetween May 2017 and April 2018, 30 procedures were performed, of which 26 biopsies and 4 drainage insertions. Of the biopsies 3 were mediastinal, 8 pulmonary, 6 retroperitoneal, 4 pelvic, and 5 of the bone. The drainages were performed for pelvic lymphoceles. The average lesion size was 3.2 cm (0.7–9 cm), with a depth from the skin of 9.1 cm (0.6–15.2 cm). The average procedure duration was 58 minutes (31–93 minutes). A conclusive histopathological diagnosis was set after 92.3% of biopsies. Three procedures resulted in complications, two being minor (hemothorax, soft tissue hematoma) and one severe (tension pneumothorax requiring drainage).ConclusionsCT guidance offers safe access to lesions that cannot be biopsied or drained under ultrasound or endoscopic guidance.

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“…For mediastinal tumors, endoscopic bronchial ultrasonography-guided 125 I radioactive seed implantation is a novel therapy that appears to be a good choice. 10,11 In this study, a retrospective analysis was performed for nonresectable stage III/IV mediastinal lung cancer or mediastinal lymph node metastasis patients treated with ultrasound bronchoscope-guided 125 I seed implantation, and no other therapies of tumor were given after the 125 I seed implantation procedure. The safety, effectiveness, and potentiality for the clinical applications of 125 I seed implantation are discussed.…”

Section: Introductionmentioning

confidence: 99%

Endobronchial Ultrasound-Guided Iodine-125 Radioactive Seed Implantation as a Novel Therapy for Mediastinal Tumors

Peng

et al. 2019

Cancer Biotherapy and Radiopharmaceuticals

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Objective: This study aims to test the treatment effect of endobronchial ultrasound (EBUS)-guided interstitial iodine-125 (125 I) seed implantation for mediastinal lymph node metastasis or advanced mediastinal lung cancer. Materials and Methods: The patients with mediastinal lymph node metastasis or advanced mediastinal lung cancer, who had undergone surgery for resection of primary lesions and repeated chemotherapy or external radiotherapy, were selected and scheduled to undergo EBUS-guided 125 I seed implantation from December 2015 to May 2017. Forty patients were included into this study. Clinical data of these patients were collected and the short-term effects were observed. Then, the feasibility for treating mediastinal tumors was retrospectively analyzed. The follow-up period ranged within 1-6 months. Results: The procedure was successfully completed, and all patients well tolerated the procedure without any major complications. The response evaluation criteria in solid tumors were utilized to test the treatment effect, and the overall response rates (complete remission + partial remission) at postoperative 2, 4, and 6 months were 65.00% (13/20), 80.00% (16/20), and 85.0% (17/20), respectively. All patients of this study survived throughout the follow-up period. Conclusions: This experience revealed that EBUS-guided 125 I radioactive seed implantation is effective and safe, and is a prospective approach for treating patients with mediastinal lymph node metastasis or advanced mediastinal lung cancer.

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Radial EBUS versus CT-guided needle biopsy for evaluation of solitary pulmonary nodules

Cited by 34 publications

References 25 publications

Endobronchial ultrasound‐guided versus computed tomography‐guided biopsy for peripheral pulmonary lesions: A meta‐analysis

Endobronchial ultrasound‐guided versus computed tomography‐guided biopsy for peripheral pulmonary lesions: A meta‐analysis

CT-guided procedures: an initial experience

Endobronchial Ultrasound-Guided Iodine-125 Radioactive Seed Implantation as a Novel Therapy for Mediastinal Tumors

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