Diagnostic Value of Endobronchial Ultrasonography With a Guide Sheath for Peripheral Pulmonary Lesions Without X-Ray Fluoroscopy

Yoshikawa, Motoko; Sukoh, Noriaki; Yamazaki, Koichi; Kanazawa, Kenya; Fukumoto, Shinichi; Harada, Masao; Kikuchi, Eiki; Munakata, Mitsuru; Nishimura, Masaharu; Isobe, Hiroshi

doi:10.1378/chest.06-2506

Cited by 174 publications

(175 citation statements)

References 23 publications

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“…The results can be generalised for patient populations where all kind of peripheral lesions are included. Previous studies indicated that endobronchial ultrasound should be reserved for small lesions(158) and patients with no CT bronchus sign should be excluded (164). The subgroup analyses from the current study did not support this selection.…”

Section: Prospective Studycontrasting

confidence: 65%

A randomised trial of endobronchial ultrasound guided sampling in peripheral lung lesions

Roth¹,

Eagan²,

Andreassen³

et al. 2011

Lung Cancer

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Section: Prospective Studycontrasting

confidence: 65%

A randomised trial of endobronchial ultrasound guided sampling in peripheral lung lesions

Roth¹,

Eagan²,

Andreassen³

et al. 2011

Lung Cancer

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“…Of these, eight were excluded: two papers enrolled less than 30 patients [18,19]; three papers examined ultrasound features of malignancy but did not report diagnostic performance of EBUS [20][21][22]; two papers were not published in English [23,24]; and one paper was a review article [25]. Therefore 16 studies formed the basis of our systematic review [12,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Inter-observer agreement for selection of studies was high: k50.855 (95% CI 0.587-1.132).…”

Section: Literature Search and Study Selectionmentioning

confidence: 99%

Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis

Steinfort¹,

Khor²,

Manser³

et al. 2010

Eur Respir J

368

309

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Improved diagnostic sensitivity of bronchsocopy for the investigation of peripheral pulmonary lesions (PPLs) with the use of radial probe endobroncial ultrasound (EBUS) has been reported, although diagnostic performance varies considerably.A systematic review of published literature evaluating radial probe EBUS accuracy was performed to determine point sensitivity and specificity, and to construct a summary receiveroperating characteristic curve. Sub-group analysis and linear regression was used to identify possible sources of study heterogeneity.16 studies with 1,420 patients fulfilled inclusion criteria. Significant inter-study variation in EBUS method was noted. EBUS had point specificity of 1.00 (95% CI 0.99-1.00) and point sensitivity of 0.73 (95% CI 0.70-0.76) for the detection of lung cancer, with a positive likelihood ratio of 26.84 (12.60-57.20) and a negative likelihood ratio of 0.28 (0.23-0.36). Significant interstudy heterogeneity for sensitivity was observed, with prevalence of malignancy, lesion size and reference standard used being possible sources.EBUS is a safe and relatively accurate tool in the investigation of PPLs. Diagnostic sensitivity of EBUS may be influenced by the prevalence of malignancy in the patient cohort being examined and lesion size. Further methodologically rigorous studies on well-defined patient populations are required to evaluate the generalisability of our results.

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“…The following studies reported that the diagnostic yield of EBUS-GS for PPLs was between 57% and 90%, and it was proved to be a safe procedure with low rate of pneumothorax and hemoptysis (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Till now there is only one randomized controlled study (22) comparing the two procedures.…”

Section: Introductionmentioning

confidence: 99%

Endobronchial ultrasonography with guide sheath versus computed tomography guided transthoracic needle biopsy for peripheral pulmonary lesions: a propensity score matched analysis

et al. 2016

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Background: Computed tomography guided transthoracic needle aspiration (CT-TTNA) and endobronchial ultrasonography with guide sheath (EBUS-GS) transbronchial lung biopsy are important methods for the diagnosis of peripheral pulmonary lesions (PPLs). Without enough evidence, it is controversial which is a better choice for diagnosing PPLs. In this study, we hypothesized that the complication rate of EBUS-GS would be lower than CT-TTNA and the diagnostic accuracy of EBUS-GS were not inferior to CT-TTNA. Methods: This study was a retrospective analysis of a prospective registry with propensity matching.Patients with PPLs were divided into EBUS-GS group and CT-TTNA group according to patients' intent to treatment. Pathological results and procedure related complications of EBUS-GS and CT-TTNA were recorded. Propensity score matching(PSM) was used to eliminate the intergroup bias. Diagnostic yields and complications of two groups were compared. Subgroup analysis was performed to conclude the indications of different procedures. Results: A total of 187 patients (CT-TTNA: 130; EBUS-GS: 57) were enrolled. After propensity score matching, 54 paired patients were included. Diagnostic yield was 81% (44/54) for EBUS-GS and 87% (47/54) for CT-TTNA (P=0.43), respectively. Diagnostic sensitivity in malignancy was 93% (42/45) for CT-TTNA and 79% (37/47) for EUBS-GS (P=0.04). Subgroup analysis revealed that the sensitivity of CT-TTNA was significantly higher in diagnosing of lesions close to the chest wall (100% vs. 80%, P=0.04), and bronchus sign on CT was a predictive factor for accurate diagnosis by EBUS-GS. The overall complication rate was 13% (7/54) for CT-TTNA group, which was not significantly higher than that of EBUS-GS group (2%, P=0.06). Subgroup analysis showed that patients combined with pulmonary comorbidities and lesions apart from chest wall were risk factors for complications of CT-TTNA. Conclusions: Both of the two procedures are effective for the diagnosis of PPLs, but CT-TTNA has a higher diagnostic sensitivity for malignancy. EBUS-GS has fewer complications, and it is more suitable for patients combined with pulmonary comorbidities and lesions with bronchus signs.

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Diagnostic Value of Endobronchial Ultrasonography With a Guide Sheath for Peripheral Pulmonary Lesions Without X-Ray Fluoroscopy

Cited by 174 publications

References 23 publications

A randomised trial of endobronchial ultrasound guided sampling in peripheral lung lesions

A randomised trial of endobronchial ultrasound guided sampling in peripheral lung lesions

Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis

Endobronchial ultrasonography with guide sheath versus computed tomography guided transthoracic needle biopsy for peripheral pulmonary lesions: a propensity score matched analysis

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