Endobronchial ultrasound-guided transbronchial needle aspiration combined with either endoscopic ultrasound-guided fine-needle aspiration or endoscopic ultrasound using the EBUS scope-guided fine-needle aspiration for diagnosing and staging mediastinal diseases: a systematic review and meta-analysis

Shen, Yanhua; Qin, Shanyu; Jiang, Hai‐Xing

doi:10.6061/clinics/2020/e1759

Cited by 5 publications

(5 citation statements)

References 34 publications

(44 reference statements)

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“…A previous meta-analysis reported that the sensitivity and specificity of PET-CT for detecting metastatic lymph nodes was 0.78 and 1.00, respectively ( 41 ). Similar results were also reported by previous meta-analyses ( 42 – 45 ). In the current study, with inclusion of more revelant studies, the sensitivity and specificity was 0.79 and 0.97 for EBUS and 0.74 and 0.99 for EUS, respectively; the staging performance in detecting metastatic lymph nodes was similar to that of PET-CT.…”

Section: Discussionsupporting

confidence: 92%

Mediastinal Nodal Staging Performance of Combined Endobronchial and Esophageal Endosonography in Lung Cancer Cases: A Systematic Review and Meta-Analysis

et al. 2022

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By searching lliteratures till January 5, 2022, we evaluated the role of the mediastinal nodal staging of endobronchial ultrasound-guided fine-needle aspiration (EBUS) and endoscopic ultrasound-guided fine-needle aspiration (EUS) in lung cancer. A total of 20 studies with 2,961 patients were included in this study. The pooled sensitivity, specificity, PLR, and NLR for EBUS were 0.79, 0.97, 27.29, and 0.25, respectively. EUS showed staging performance similar to EBUS. The staging performance was significantly improved when combining EBUS + EUS.

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Section: Discussionsupporting

confidence: 92%

Mediastinal Nodal Staging Performance of Combined Endobronchial and Esophageal Endosonography in Lung Cancer Cases: A Systematic Review and Meta-Analysis

et al. 2022

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“…On the other hand, the studies show that both the combined EBUS and EUS strategies and the EBUS and EUS-b procedures are valid options for staging. Although some authors have reported higher S values with the first one (87% vs. 84%) [15], and others with the second one (85% vs. 88%) [12], the results are similar for both approaches.…”

Section: Discussionmentioning

confidence: 63%

“…The clinical practice guidelines recommend sampling the mediastinum with minimally invasive techniques, such as endobronchial ultrasound (EBUS) or endoscopic ultrasound (EUS) with fine-needle aspiration, both of which show a diagnostic yield comparable to the mediastinoscopy, which remains the gold standard to date [2,[4][5][6]. Several meta-analyses have shown a higher yield in staging by combining EBUS and EUS as a single technique because it makes it possible to access most lymph node stations and is more sensitive in the detection of lymph node metastasis than EBUS or EUS alone (global sensitivity [S] 0.86-0.91%) [10][11][12][13][14][15]. This increase in S by combining both tests depend on the quality of the procedure [16].…”

Section: Introductionmentioning

confidence: 99%

“…In lung cancer patient with radiographically obvious mediastinal involvement, the diagnostic yield with the combined use of both tests has been previously demonstrate [10][11][12][13]15]. Systematic staging in these patients with the sampling of all the lymph node stations regardless of PET with CT (PET-CT) uptake shows better results because it can detect lymph node metastases that are not detected by these imaging tests.…”

Section: Introductionmentioning

confidence: 99%

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The Value of a Systematic Protocol Using Endobronchial Ultrasound and Endoscopic Ultrasound in Staging of Lung Cancer for Patients with Imaging iN0–N1 Disease

et al. 2021

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Introduction: We hypothesize that systematic, combined, and multidisciplinary study of the mediastinum (endobronchial ultrasound [EBUS] and endoscopic ultrasound [EUS]) in patients with NSCLC with radiologically normal mediastinum improves the results of mediastinal staging obtained with EBUS alone. Material and Methods: A retrospective study of the prospective database collected on the patients with NSCLC with a radiologically normal mediastinum and an indication for systematic staging with EBUS and EUS. EBUS staging was followed by EUS in patients in which the results from the pathological analysis of EBUS were negative. Results: Forty-five patients were included in the analysis. The combination of EBUS followed by EUS provided better results than EBUS alone: sensitivity (S) 95% versus 80%, negative predictive value (NPV) 96.15% versus 86.21%, negative likelihood ratio 0.05 versus 0.20, and post-test probability 3.8% versus 13.8%. This represents an increase in S (15%), the validity index (6.6%), and NPV (9.9%) compared to EBUS alone. There were 4 false negatives (FNs) (8.8%) with the EBUS test alone. After adding EUS, 3 more cases were positive (6.6%) and only 1 FN (2.2%). Conclusions: In patients with NSCLC and a radiographically normal mediastinum, a systematic and combined staging with EBUS and EUS show higher sensitivity in the detection of mediastinal metastasis than with the use of EBUS alone. The high accuracy of the test means that the use of mediastinoscopy is not necessary to confirm the results in these patients. Since the availability of EUS is low, it may be advisable for the interventional pulmonologist to receive training in EUS-b.

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“…EBUS-TBNA identifies the puncture site through real-time ultrasound guidance, allowing accurate sampling from lesions and cytological and histological diagnosis. The cumulative sensitivity of EUBS-TBNA is 88%-93% and the cumulative specificity is 100% in lymph node staging of lung cancer[ 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

Severe mediastinitis and pericarditis after endobronchial ultrasound-guided transbronchial needle aspiration: A case report

Koh¹,

Kim²,

Kang³

et al. 2021

WJCC

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BACKGROUND Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and minimally invasive diagnostic tool for mediastinal and hilum evaluation. However, infectious complications may occur after EBUS-TBNA. Among these, mediastinitis and pericarditis are rare. CASE SUMMARY A 67-year-old woman was referred to our hospital due to paratracheal lymph node enlargement on chest computed tomography (CT). EBUS-TBNA was performed on the lymph node lesions, and prophylactic oral antibiotics were administered. Seven days after EBUS-TBNA, the patient visited the emergency room with a high fever and chest pain. Laboratory test results revealed leukocytosis with a left shift and elevated C-reactive protein level (25.7 mg/dL). Chest CT revealed the formation of a mediastinal abscess in the right paratracheal lymph node and pericardial and bilateral pleural effusions. The patient received intravenous antibiotic treatment, cardiac drainage through pericardiocentesis, and surgical management. The patient recovered favorably and was discharged 31 d after the operation. CONCLUSION Mediastinitis and pericarditis after EBUS-TBNA are rare but should be considered even after the use of prophylactic antibiotics.

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Endobronchial ultrasound-guided transbronchial needle aspiration combined with either endoscopic ultrasound-guided fine-needle aspiration or endoscopic ultrasound using the EBUS scope-guided fine-needle aspiration for diagnosing and staging mediastinal diseases: a systematic review and meta-analysis

Cited by 5 publications

References 34 publications

Mediastinal Nodal Staging Performance of Combined Endobronchial and Esophageal Endosonography in Lung Cancer Cases: A Systematic Review and Meta-Analysis

Mediastinal Nodal Staging Performance of Combined Endobronchial and Esophageal Endosonography in Lung Cancer Cases: A Systematic Review and Meta-Analysis

The Value of a Systematic Protocol Using Endobronchial Ultrasound and Endoscopic Ultrasound in Staging of Lung Cancer for Patients with Imaging iN0–N1 Disease

Severe mediastinitis and pericarditis after endobronchial ultrasound-guided transbronchial needle aspiration: A case report

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