A Randomized Clinical Trial of Flex 19G Needles versus 22G Needles for Endobronchial Ultrasonography in Suspected Lung Cancer

Dooms, Christophe; Borght, Sara Vander; Yserbyt, Jonas; Testelmans, Dries; Wauters, Els; Nackaerts, Kristiaan; Vansteenkiste, Johan; Verbeken, Eric; Weynand, Birgit

doi:10.1159/000489473

Cited by 45 publications

(31 citation statements)

References 17 publications

(19 reference statements)

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“…In other centers a part of these patients would include benign disease such post infection lymphadenopathy or sarcoidosis. We observed in our study again as it has been previously identified that 19G needle has larger biopsy sample almost double the size of a 22G needle 8 , 16 . The biopsy sample size was as follows in our study; d>c=b>a based on the needles.…”

Section: Discussionsupporting

confidence: 88%

Priority of PET-CT vs CT Thorax for EBUS-TBNA 22G vs 19G: Mesothorax Lymphadenopathy

Huang¹,

Hu²,

Wu³

et al. 2021

J. Cancer

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Introduction: Lung lesions and undiagnosed mesothorax lymphadenopathy is an issue that several doctors face in the everyday clinical practice. PET-CT and CT of the thorax are usually the first examinations to identify characteristics of the lesions before biopsy. Patients and Methods: We performed a retrospective study with 450 patients that had EBUS-TBNA with 22G, Upgraded 22G and 19G needles with and without PET-CT in order to identify the cost effeteness of performing EBUS-TBNA before or after PET-CT. All centers used the same PET-CT equipment and EBUS-TBNA system. Three types of needle were used for the endoscopy in order to identify similarities and differences for the cost-effectiveness. The costs in every center for every examination and materials were the same. Results: There were more block slices for 19G>22Gupgraded>21G>22G and there was cost-effectiveness when in general PET-CT was performed prior to biopsy of any lesion. 19G needle was more effective for lymphomas, while 22Gupgraded and 21G needles were more cost-effective when used for smaller lesions for primary lung cancer of metastatic disease. Conclusions: We have been using PET-CT and EBUS-TBNA in the everyday clinical practice according to the current guidelines for initial disease staging and re-staging. However; we can also use both in a cost effective method based on the initial radiologic findings.

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Section: Discussionsupporting

confidence: 88%

Priority of PET-CT vs CT Thorax for EBUS-TBNA 22G vs 19G: Mesothorax Lymphadenopathy

Huang¹,

Hu²,

Wu³

et al. 2021

J. Cancer

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“…After validation by AccuRef Diagnostics, the sets of unstained slides (A‐D) were distributed to the 17 laboratories; some of the laboratories that specialized in NGS testing of cytological samples had also taken part in the working group of the latest annual meeting on molecular cytopathology held in Naples, Italy (Fig. ) . Each laboratory stained the slides by applying their own routine protocols (Diff Quik, Papanicolaou, or hematoxylin‐eosin staining).…”

Section: Methodsmentioning

confidence: 99%

Consistency and reproducibility of next‐generation sequencing in cytopathology: A second worldwide ring trial study on improved cytological molecular reference specimens

Pisapia

Malapelle

Roma

et al. 2019

Cancer Cytopathology

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Background Artificial genomic reference standards in a cytocentrifuge/cytospin format with well‐annotated genomic data are useful for validating next‐generation sequencing (NGS) on routine cytopreparations. Here, reference standards were optimized to be stained by different laboratories before DNA extraction and to contain a lower number of cells (2 × 105). This was done to better reflect the clinical challenge of working with insufficient cytological material. Methods A total of 17 worldwide laboratories analyzed customized reference standard slides (slides A‐D). Each laboratory applied its standard workflow. The sample slides were engineered to harbor epidermal growth factor receptor (EGFR) c.2235_2249del15 p.E746_A750delELREA, EGFR c.2369C>T p.T790M, Kirsten rat sarcoma viral oncogene homolog (KRAS) c.38G>A p.G13D, and B‐Raf proto‐oncogene, serine/threonine kinase (BRAF) c.1798_1799GT>AA p.V600K mutations at various allele frequencies (AFs). Results EGFR and KRAS mutation detection showed excellent interlaboratory reproducibility, especially on slides A and B (10% and 5% AFs). On slide C (1% AF), either the EGFR mutation or the KRAS mutation was undetected by 10 of the 17 laboratories (58.82%). A reassessment of the raw data in a second‐look analysis highlighted the mutations (n = 10) that had been missed in the first‐look analysis. BRAF c.1798_1799GT>AA p.V600K showed a lower concordance rate for mutation detection and AF quantification. Conclusions The data show that the detection of low‐abundance mutations is still clinically challenging and may require a visual inspection of sequencing reads to detect. Genomic reference standards in a cytocentrifuge/cytospin format are a valid tool for regular quality assessment of laboratories performing molecular studies on cytology with low‐AF mutations.

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“…For common indications, commercially available 21-or 22-gauge (G) needles were shown to be safe and equally effective in providing adequate diagnostic yield (5). More recently, a 19G needle has become commercially available and may provide the advantage of yielding larger cell blocks, possibly allowing to reduce the number of needle passes and overall procedure time, without compromising diagnostic accuracy (42)(43)(44). Biopsy specimens can also be obtained by transbronchial forceps introduced into the target lesion via the bronchial wall opening already established by the TBNA needle, thus providing histology-grade specimens and potentially increasing the diagnostic yield in certain benign and malignant conditions (45,46).…”

Section: Utility Of Convex-probe Ebus and Transbronchial Needle Aspiration In The Icumentioning

confidence: 99%

An evolving role for endobronchial ultrasonography in the intensive care unit

Kalchiem‐Dekel¹,

Hossain²,

Gauran³

et al. 2021

J Thorac Dis

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Endobronchial ultrasound (EBUS) bronchoscopy is an established minimally-invasive modality for visualization, characterization, and guidance of sampling of paratracheal and parabronchial structures and tissues. In the intensive care unit (ICU), rapidly obtaining an accurate diagnosis is paramount to the management of critically ill patients. In some instances, diagnosing and confirming terminal illness in a critically ill patient provides needed closure for patients and their loved ones. Currently available data on feasibility, safety, and yield of EBUS bronchoscopy in critically ill patients is based on single center experiences. These data suggest that in select ICU patients convex and radial probe-EBUS bronchoscopy can serve as useful tools in the evaluation of mediastinal lymphadenopathy, central airway obstruction, pulmonary embolism, and peripheral lung lesions. Barriers to the use of EBUS bronchoscopy in the ICU include: (I) requirement for dedicated equipment, prolonged procedure time, and bronchoscopy team expertise that may not be available; (II) applicability to a limited number of patients and conditions in the ICU; and (III) technical difficulty related to the relatively large outer diameter of the convex probe-EBUS bronchoscope and an increased risk for adverse cardiopulmonary consequences due to intermittent obstruction of the artificial airway. While the prospects for EBUS bronchoscopy in critically ill patients appear promising, judicious patient selection in combination with bronchoscopy team expertise are of utmost importance when considering performance of EBUS bronchoscopy in the ICU setting.

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A Randomized Clinical Trial of Flex 19G Needles versus 22G Needles for Endobronchial Ultrasonography in Suspected Lung Cancer

Cited by 45 publications

References 17 publications

Priority of PET-CT vs CT Thorax for EBUS-TBNA 22G vs 19G: Mesothorax Lymphadenopathy

Priority of PET-CT vs CT Thorax for EBUS-TBNA 22G vs 19G: Mesothorax Lymphadenopathy

Consistency and reproducibility of next‐generation sequencing in cytopathology: A second worldwide ring trial study on improved cytological molecular reference specimens

An evolving role for endobronchial ultrasonography in the intensive care unit

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