Underutilization of Transbronchial Needle Aspiration

Haponik, Edward F.; Shure, Deborah

doi:10.1378/chest.112.1.251

Cited by 149 publications

(100 citation statements)

References 14 publications

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“…TBNA use for the evaluation of lymph node involvement has been popularised by the works of WANG and coworkers [13][14][15], but it remains largely underutilised, despite its safety, mainly because of concerns about the practice learning curve [8]. This factor could also explain the wide range of diagnostic yields reported in the literature [5,8].…”

Section: Limitations Of the Studymentioning

confidence: 99%

“…This factor could also explain the wide range of diagnostic yields reported in the literature [5,8]. Until recently, the procedure was performed without guidance and, in order to compensate for this drawback and to increase diagnostic yield, repeated aspirates, up to a total number of seven, and/or rapid on-site sample evaluation have been proposed [16].…”

Section: Limitations Of the Studymentioning

confidence: 99%

“…Transbronchial needle aspiration (TBNA) of lymph nodes, which was developed .50 yrs ago [7], may circumvent some of the drawbacks of mediastinoscopy. Surprisingly, this technique remains largely underutilised [8] and this is probably explained, at least in part, by concerns about the practice learning curve and by the fact that, until recently, this procedure was not guided by imaging. In a recent study, HERTH et al [9] have shown that TBNA might be assisted by previous localisation of mediastinal lymph nodes using a new tool, endobronchial ultrasound (EBUS).…”

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confidence: 99%

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Endobronchial ultrasound and positron emission tomography positive mediastinal lymph nodes

Plat

Pierard²,

Haller³

et al. 2006

Eur Respir J

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Positron emission tomography with 18F-fluoro-2-deoxy-D-glucose (FDG-PET) is more accurate than computed tomography for staging of mediastinal (hilar) lymph nodes. In the case of positive findings, tissue sampling of lymph nodes is required. The diagnostic/staging yield of transbronchial needle aspiration (TBNA) following endobronchial ultrasound (EBUS) localisation was assessed in this particular clinical setting. The number of avoided surgical procedures was evaluated.All consecutive patients referred for staging and/or diagnosis of mediastinal FDG-PET positive lesions were included. Data were prospectively collected. TBNA sampling of lymph nodes was performed after EBUS localisation. If no diagnosis was reached, further surgical sampling or adequate follow-up was performed.From January 2003 to June 2004, 33 patients were included. The average number of TBNA samples per patient was 4.2¡1.5. Cytological or histological diagnoses were obtained in 27 (82%) of the patients, of which 78% were obtained after previous EBUS localisation. In 25 (76%) of the 33 patients, surgical staging procedures were suppressed.In conclusion, transbronchial needle aspiration after endobronchial ultrasound localisation should be considered as a primary method of evaluation of lymph nodes positive by positron emission tomography with 18F-fluoro-2-deoxy-D-glucose, and may replace the majority of surgical mediastinal staging/diagnostic procedures.

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Section: Limitations Of the Studymentioning

confidence: 99%

Section: Limitations Of the Studymentioning

confidence: 99%

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confidence: 99%

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Endobronchial ultrasound and positron emission tomography positive mediastinal lymph nodes

Plat

Pierard²,

Haller³

et al. 2006

Eur Respir J

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“…Furthermore, it was reported that only about 10% of pulmonologists performed TBNA routinely for diagnosing or staging malignant diseases. 5) Nowadays, the popularity of EBUS-TBNA is increasing worldwide. A convex-probe (CP) EBUS allows realtime imaging under direct US guidance.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Utility of Real-Time EBUS-TBNA for Hilar and Mediastinal Lymph Nodes in Conventional TBNA Negative Patients

Çetınkaya

Özgül

Tutar

et al. 2014

ATCS

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Background: There are many causes of mediastinal and hilar lymphadenopathy, such as neoplasms, granulomatous diseases, infections and reactive hyperplasia. Nowadays, the popularity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is increasing in the diagnosis of mediastinal and hilar lymphadenopathy. We aimed to investigate the diagnostic value of EBUS-TBNA in patients with mediastinal and/or hilar lymphadenopathy and previously conventional TBNA-negative or inadequate results. Methods: Retrospective analysis was performed in 64 patients with previously conventional TBNA-negative or inadequate results and consequently undergoing EBUS-TBNA between July 2007 and August 2011. Results: One hundred and twenty three lymph nodes were sampled by EBUS-TBNA in 64 patients with no complications. In the 63 (98.4%) cases with adequate results, the sensitivity, diagnostic accuracy, and NPV of EBUS-TBNA per patient was 90.5%, 90.6%, and 66.6%, respectively. In a total of 122 (99.1%) adequately sampled lymph nodes, the diagnostic sensitivity, accuracy, and NPV of EBUS-TBNA per nodal station were 87.8%, 90.1%, and 65.7%, respectively. Non-small cell lung cancer (NSCLC) (n = 21, 33.3%) and sarcoidosis (n = 16, 25.3%) were the most common malignant and benign diseases in the patients with adequate samples by EBUS-TBNA. The relationships of diagnostic accuracy with the number of lymph nodes sampled, number of passes per node, or size of lymph nodes were both insignifi cant ( p >0.05). Conclusion: EBUS-TBNA is a sensitive and accurate method for the assessment of mediastinal and hilar lymph nodes in patients with conventional TBNA negative results.

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“…The yield of TBNA is related to the size and location of the lesion, as well as the individual experience of the physician (3,4). Although TBNA has been shown to be effective in mediastinal lung cancer staging, TBNA is underutilized and is not formally taught in training programs (2,5). Although rapid on-site evaluation (ROSE) and obtaining ≤ 7 aspirates have been proposed to improve the yield, ROSE often requires expensive and sophisticated instrumentation (6).…”

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confidence: 99%

Conventional vs. endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal lymphadenopathies

Arslan¹

2011

Tuberk Toraks

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Underutilization of Transbronchial Needle Aspiration

Cited by 149 publications

References 14 publications

Endobronchial ultrasound and positron emission tomography positive mediastinal lymph nodes

Endobronchial ultrasound and positron emission tomography positive mediastinal lymph nodes

The Diagnostic Utility of Real-Time EBUS-TBNA for Hilar and Mediastinal Lymph Nodes in Conventional TBNA Negative Patients

Conventional vs. endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal lymphadenopathies

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