A Prospective, Randomized Trial for the Comparison of 19-G and 22-G Endobronchial Ultrasound-Guided Transbronchial Aspiration Needles; Introducing a Novel End Point of Sample Weight Corrected for Blood Content

Wolters, Celina; Darwiche, Kaid; Franzen, Daniel; Hager, Thomas; Bode-Lesnievska, Beata; Kneuertz, Peter J.; He, Kai; Koenig, Michael J.; Freitag, Lutz; Wei, Lai; Eisenmann, Stephan; Taube, Christian; Weinreich, Gerhard; Oezkan, Filiz

doi:10.1016/j.cllc.2019.02.019

Cited by 27 publications

(28 citation statements)

References 32 publications

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“…One systematic review from a clinical practice guideline produced on behalf of the World Association of Bronchology and Interventional Pulmonology Task Force, 27 2 randomized controlled trials (RCTs), 28,29 2 prospective cohort studies, 30,31 and 4 retrospective cohort studies [32][33][34][35] comprise the evidence base for statement 2. The systematic review 27 carried a low risk of bias, with the only limitation being unclear reporting of whether the study used dual study selection and data extraction.…”

Section: Guideline Statements Endobronchial Ultrasound-guided Transbronchial Proceduresmentioning

confidence: 99%

“…The systematic review 27 carried a low risk of bias, with the only limitation being unclear reporting of whether the study used dual study selection and data extraction. Both RCTs, 28,29 1 prospective cohort study, 31 and all the retrospective cohort studies [32][33][34][35] were published after the search date of the systematic review. The aggregate risk of bias across these studies was very serious.…”

Section: Guideline Statements Endobronchial Ultrasound-guided Transbronchial Proceduresmentioning

confidence: 99%

“…The aggregate risk of bias across these studies was very serious. 28,29,[31][32][33][34][35] An additional prospective cohort study, 30 which did not evaluate needle gauge in relation to sufficiency for ancillary testing but did report on the outcome, was included as indirect evidence for this statement and was limited by a serious risk of bias. None of the studies were found to have methodologic flaws that would raise concerns about the findings.…”

Section: Guideline Statements Endobronchial Ultrasound-guided Transbronchial Proceduresmentioning

confidence: 99%

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Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies: Guideline From the College of American Pathologists in Collaboration With the American College of Chest Physicians, Association for Molecular Pathology, American Society of Cytopathology, American Thoracic Society, Pulmonary Pathology Society, Papanicolaou Society of Cytopathology, Society of Interventional Radiology, and Society of Thoracic Radiology

Roy‐Chowdhuri

Đačić

Ghofrani

et al. 2020

Archives of Pathology & Laboratory Medicine

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Context.— The need for appropriate specimen use for ancillary testing has become more commonplace in the practice of pathology. This, coupled with improvements in technology, often provides less invasive methods of testing, but presents new challenges to appropriate specimen collection and handling of these small specimens, including thoracic small biopsy and cytology samples. Objective.— To develop a clinical practice guideline including recommendations on how to obtain, handle, and process thoracic small biopsy and cytology tissue specimens for diagnostic testing and ancillary studies. Methods.— The College of American Pathologists convened an expert panel to perform a systematic review of the literature and develop recommendations. Core needle biopsy, touch preparation, fine-needle aspiration, and effusion specimens with thoracic diseases including malignancy, granulomatous process/sarcoidosis, and infection (eg, tuberculosis) were deemed within scope. Ancillary studies included immunohistochemistry and immunocytochemistry, fluorescence in situ hybridization, mutational analysis, flow cytometry, cytogenetics, and microbiologic studies routinely performed in the clinical pathology laboratory. The use of rapid on-site evaluation was also covered. Results.— Sixteen guideline statements were developed to assist clinicians and pathologists in collecting and processing thoracic small biopsy and cytology tissue samples. Conclusions.— Based on the systematic review and expert panel consensus, thoracic small specimens can be handled and processed to perform downstream testing (eg, molecular markers, immunohistochemical biomarkers), core needle and fine-needle techniques can provide appropriate cytologic and histologic specimens for ancillary studies, and rapid on-site cytologic evaluation remains helpful in appropriate triage, handling, and processing of specimens.

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Section: Guideline Statements Endobronchial Ultrasound-guided Transbronchial Proceduresmentioning

confidence: 99%

Section: Guideline Statements Endobronchial Ultrasound-guided Transbronchial Proceduresmentioning

confidence: 99%

Section: Guideline Statements Endobronchial Ultrasound-guided Transbronchial Proceduresmentioning

confidence: 99%

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Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies: Guideline From the College of American Pathologists in Collaboration With the American College of Chest Physicians, Association for Molecular Pathology, American Society of Cytopathology, American Thoracic Society, Pulmonary Pathology Society, Papanicolaou Society of Cytopathology, Society of Interventional Radiology, and Society of Thoracic Radiology

Roy‐Chowdhuri

Đačić

Ghofrani

et al. 2020

Archives of Pathology & Laboratory Medicine

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“…A more recent study using material from EBUS procedures 27 weighed the samples from 19G and 22G needles and found a mean weight per pass of 10.2 mg (0.0102 g) in the 22G group and 20.0 mg (0.02 g) in the 19G group. The nodes were sampled with three to five passes, each with 10‐15 needle thrusts.…”

Section: Discussionmentioning

confidence: 99%

Rapid onsite evaluation uses a very small proportion of total material aspirated at endobronchial or endoscopic ultrasound in the investigation of suspected thoracic malignancy

et al. 2021

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Introduction The objectives were: to measure the proportion of aspirated material used to make direct slides for rapid onsite evaluation (ROSE) at endobronchial (EBUS) and endoscopic ultrasound (EUS) in suspected thoracic malignancy; and to correlate pass weights with ROSE category and needle size. Method All EBUS and EUS cases for possible thoracic malignancy October 2018‐May 2019 were included. All material from each pass was expelled into a Petri dish. One drop of material was placed on each of two slides; one used for ROSE, the other fixed and remaining material processed to cell block. Dish and slides were weighed before and after this procedure on a sensitive balance and weight of aspirate and slide material calculated. When ROSE identified malignancy, slide production ceased but target sampling for ancillary studies continued. Results ROSE accuracy was 96.8%. Mean percentage by target of aspirated material used to make direct slides for ROSE was 1.9% in malignant cases and 3.6% in non‐malignant cases (P = .027 for difference). Mean percentage by pass was 5.9%. Mean weight of a single aspirate was 128.8 mg. Mean weight of aspirates insufficient on ROSE (175.7 mg) was significantly higher than the mean weight of benign or malignant aspirates (117.1 and 114.0 mg, respectively). Mean weight of aspirates using 22G needles (132.6 mg) was significantly higher than that for 25G needles (87.1 mg). Conclusion Material made into direct slides at EBUS and EUS and used in part for ROSE uses a tiny proportion of aspirated material with over 98% processed to cell block and available for ancillary testing in malignant cases.

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“…As for the needle, the models available at present are mainly 25G, 22G, and 19G. In terms of sample quantity, 19G is better than 22G, with equivalent safety (10). The 22G and the 25G needles show no significant difference in diagnostic accuracy (11).…”

Section: Tbna and Intranodal Forceps Biopsy (Ifb)mentioning

confidence: 99%

Recent advances in convex probe endobronchial ultrasound: a narrative review

Zhou

et al. 2021

Ann Transl Med

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Convex probe endobronchial ultrasound (CP-EBUS) has been widely used in the lymph node staging and restaging of lung tumors and the diagnosis of mediastinal diseases. Recent years have seen continuous progress in this technology. For diagnosis, elastography technology can preliminarily distinguish between benign and malignant lesions, so that reduce the number of punctures. CP-EBUS can also be used as an endoscopic ultrasound (EUS) to guide needle aspirations of liver lesions, retroperitoneal lymph nodes and left adrenal gland (LAG) lesions sometimes. Some advances help diagnosing more accurately and effectively, such as the intranodal forceps biopsy (IFB), the new type of 22G needle, the rapid on-site evaluation (ROSE) and the cancer gene methylation, etc. In addition, special advances are being made in diagnosis using artificial intelligence (AI). For treatment, CP-EBUS has yielded novel research results when applied to transbronchial needle injection (TBNI) and radioactive seed implantation in clinical cases, and blocking of the cardiac plexus in animal studies. The next-generation CP-EBUS is also ready for use in the clinic and the technology will be improving continuously. Through this review, we hope to educate clinicians on the latest uses of CP-EBUS and open up further research ideas for readers interested in this technology.

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A Prospective, Randomized Trial for the Comparison of 19-G and 22-G Endobronchial Ultrasound-Guided Transbronchial Aspiration Needles; Introducing a Novel End Point of Sample Weight Corrected for Blood Content

Cited by 27 publications

References 32 publications

Rapid onsite evaluation uses a very small proportion of total material aspirated at endobronchial or endoscopic ultrasound in the investigation of suspected thoracic malignancy

Recent advances in convex probe endobronchial ultrasound: a narrative review

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