The diagnostic efficacy and safety of endobronchial ultrasound-guided transbronchial needle aspiration as an initial diagnostic tool

Abstract

Background/AimsReal-time, convex probe endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is used for the staging of malignant mediastinal lymph nodes. We evaluated the diagnostic efficacy and safety of EBUS-TBNA when used as an initial diagnostic tool.MethodsWe retrospectively studied 56 patients who underwent EBUS-TBNA as an initial diagnostic tool between August 2010 and December 2011. Procedure purpose were classified into four categories: 1) intrathoracic masses adjacent to the central airway; 2) enlarged lymph nodes for concurrent diagnosis and staging in suspected malignancy; 3) enlarged lymph nodes in suspected malignancy cases with inability to perform percutaneous core needle biopsy (PCNB); and 4) solely mediastinal masses/lymph nodes in lieu of mediastinoscopy.ResultsThe diagnostic accuracy of EBUS-TBNA regardless of procedure purpose was calculated to be 83.9%. Furthermore, the diagnostic accuracy of malignant disease was significantly higher than benign disease (93.9% vs. 70.6%, p < 0.001). The diagnostic accuracy of EBUS-TBNA for each disease is as follows: tuberculosis, 50%; sarcoidosis, 60%; aspergillosis, 100%; lung abscess, 100%; lung cancer, 93%; and lymphoma, 100%. There were minor complications in seven patients during the EBUS-TBNA procedure. The complications included mild hypoxia and bleeding.ConclusionsIn conclusion, EBUS-TBNA is a useful initial diagnostic tool for both benign and malignant diseases. EBUS-TBAN is also a very safe procedure and less invasive compared to mediastinoscopy or PCNB.

Diagnostic Efficacy and Safety of Endobronchial Ultrasound‐Guided Transbronchial Needle Aspiration in Intrathoracic Tuberculosis

“…One additional article was identified from the references of the retrieved papers. Finally, a total of 8 studies 6,10,11,[13][14][15][16][17] were included in the meta-analysis ( Figure 1).…”

“…13,15 Four studies were performed in countries with a high incidence of TB, including China 6,10,14 and Korea. 13 The others were done in Turkey, 15,16 the United Kingdom, 11 and Ireland. 17 The sensitivity of EBUS-TBNA for diagnosis of intrathoracic TB ranged from 0.5 to 0.95, and the specificity ranged from 0.917 to 1.0.…”

Middle mediastinal schwannoma concealed by asthma and GORD

“…EUS-FNA allows better access to the posterior mediastinum that cannot be accessed by EBUS-TBNA, while EBUS-TBNA is well established in sampling subcarinal and right paratracheal areas 19. However, combination of both still limits the access of the anterior mediastinum 20.…”

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Increases the Yield of Transbronchial Lung Biopsy for the Evaluation of Peribronchial Lesions

“…Choi et al . [7] also reported that the diagnostic accuracy of EBUS-TBNA was higher for malignant diseases than for benign diseases. However, in other studies, the diagnostic accuracy of EBUS-TBNA for benign granulomatous disorders was not significantly different from that observed for malignant diseases.…”