Transbronchial needle aspiration accurately diagnoses subcentimetre mediastinal and hilar lymph nodes detected by integrated positron emission tomography and computed tomography

Hsu, Li‐Han; Ko, Jen‐Sheng; You, Dong-Ling; Liu, Chia‐Chuan; Chu, Nai‐Shin

doi:10.1111/j.1440-1843.2007.01164.x

Cited by 15 publications

(15 citation statements)

References 22 publications

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“…Similar results were obtained in four out of seven studies, involving patients with suspected/known lung cancer [20,21,22,25]. The remaining studies reported no significant difference in TBNA sensitivity depending on the lymph node sizes [34,35,36]. The only study performed on patients with suspected sarcoidosis did not detect any significant difference [30].…”

Section: Resultssupporting

confidence: 71%

Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

et al. 2013

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Background: Transbronchial needle aspiration (TBNA) is a safe and useful sampling technique for the diagnosis of mediastinal adenopathies/masses, but its accuracy seems to be influenced by selected clinical and procedural aspects. Objectives: We performed a systematic review to identify the main predictors of a successful transbronchial aspirate according to different clinical settings. Methods: We searched Medline and Embase for all studies evaluating predictors of TBNA diagnostic yield, published up to February 2012. Two authors reviewed all titles/abstracts and retrieved the full text of articles that are potentially relevant to identify studies according to predefined selection criteria. The methodological quality of studies was assessed through the revised Quality Assessment of Diagnostic Accuracy Studies tool. Evidence synthesis was graded according to overall number of studies, patients involved and methodological features. Results: Fifty-three studies, involving more than 8,000 patients and evaluating 23 potential predictive factors, were included. Major predictors in an unselected population, as well as in patients with suspected/known lung cancer, included lymph node size (short axis length ≥2 cm), presence of abnormal endoscopic findings, subcarinal and right paratracheal location, and the use of histological needle by an experienced bronchoscopist. Stage I and sampling of more than one lymph node stations were the only predictors of a successful TBNA result in patients with suspected sarcoidosis. Conclusions: The diagnostic yield of TBNA depends on selected clinical and procedural features. Knowledge of factors that predict a positive TBNA result may help optimize the diagnostic success of the procedure in different clinical settings.

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Section: Resultssupporting

confidence: 71%

Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

et al. 2013

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“…We observed a survival benefit for pure BAC patients diagnosed according to the WHO classification released in 1999. An earlier hilar-mediastinal recurrence is also detectable by sequential serum carcino-embryonic antigen follow-up and PET/CT-guided transbronchial needle aspiration [13]. Clinical trials have demonstrated patients with pure BAC disproportionately respond to EGFR-TKIs [37].…”

Section: Discussionmentioning

confidence: 97%

“…All suspicious N2 and/or N3 lymph nodes (maximum standardized uptake value ≥2.5 on integrated positron emission tomography and computed tomography, PET/CT or ≥1 cm on the shorter axis on computed tomography, CT) with a clinically relevant impact on cancer management were biopsied. Mediastinoscopy and/or transbronchial needle aspiration were used to biopsy different nodal stations as previously described [13]. All suspicious metastatic (M1) sites determined by PET/CT or CT was also investigated and/or biopsied.…”

Section: Stagingmentioning

confidence: 99%

Sex-associated differences in non-small cell lung cancer in the new era: Is gender an independent prognostic factor?

et al. 2009

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“…There are studies with results suggesting increased DY of C-TBNA with higher SUVmax on PET/CT, but these studies define diverse range of SUVmax cut-offs such as 2.5, 3 and 5 (15)(16)(17). In this study, a limited percentage of patients (34.9%) had undergone PET/CT.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients

Öztürk¹,

Sandal

Karahan³

et al. 2016

Tuberk Toraks

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SUMMARY Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients Introduction: Conventional transbronchial needle aspiration biopsy (C-TBNA) is a technique in evaluating mediastinal/hilar lymph nodes (LN). We aimed to investigate diagnostic yield (DY) and safety of C-TBNAs performed in a single university clinic. Patients and Methods: We retrospectively reviewed 363 consecutive C-TBNA procedures in 219 patients. The DY and its relationship with location, shortest diameter, SUVmax of LN, and number of sampled stations were evaluated.Results: Procedures were diagnostic in 257 (71%) LNs. The most common diagnoses were malignancy (n= 109.30%) and granulomatous inflammation (n= 68, 18.7%) biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients INTRODUCTIONTransbronchial needle aspiration (TBNA) is a minimally invasive technique for lymph node (LN) sampling to investigate etiologies of mediastinal and hilar LNs. Although TBNA was firstly described in 1949, fiberoptic bronchoscopic application was defined in 1981 (1,2). Besides conventional usage with white light bronchoscopy (C-TBNA), its bronchoscopic appliance can also be guided by newer imaging methods like endobronchial ultrasound (EBUS-TBNA).Conventional TBNA is a minimally invasive, safe, and cost-effective technique in evaluating mediastinal and enlarged LNs. Emergence and increasing use of EBUS-TBNA provided more information about this newer technique's diagnostic success and gave the opportunity to compare it with that of C-TBNA. The meta-analyses performed for the 3 rd edition of American College of Chest Physicians (ACCP) Diagnosis and Management of Lung Cancer Guideline yielded mean pooled sensitivities of 78% and 89% for C-TBNA and EBUS-TBNA, respectively (3). There are randomized trials with results suggesting better diagnostic results with EBUS-TBNA in both lung cancer and sarcoidosis patients (4-6). Despite better diagnostic results of TBNA with additional imaging, requirement for advanced devices, special equipment and experienced staff for the specific procedure makes wide range application of those techniques uneasy (7). Thus, C-TBNA may still be important for LN sampling in terms of feasibility and practicality. Herein we report the diagnostic yield (DY) and safety of C-TBNA performed in a single center at a university clinic. PATIENTS and METHODS PatientsThe study included 363 consecutively performed C-TBNA procedures in 219 patients who underwent fiberoptic bronchoscopy and C-TBNA in the Bronchoscopy Unit of Hacettepe University Adult Hospital between October 1 st , 2012 and December 31 st , 2014. With the retrospective design, the study was approved by Hacettepe University Non-interventional Clinical Researches Ethical Committee. The files of the patients were reviewed retrospectively and available study forms were duly filled in. The age, gender, radiological findings, bronchoscopic findings, sampled...

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Transbronchial needle aspiration accurately diagnoses subcentimetre mediastinal and hilar lymph nodes detected by integrated positron emission tomography and computed tomography

Abstract: PET/CT can identify small malignant lymph nodes that can then be successfully biopsied by TBNA with on-site cytopathology.

Cited by 15 publications

References 22 publications

Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

Sex-associated differences in non-small cell lung cancer in the new era: Is gender an independent prognostic factor?

Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients

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