EBUS-TBNA for the diagnosis of central parenchymal lung lesions not visible at routine bronchoscopy

Tournoy, Kurt G.; Rintoul, Robert C.; Meerbeeck, Jan P. van; Carroll, Nicholas; Praet, Marleen; Buttery, Robert; Kralingen, Klaas W. van; Rabe, Klaus F.; Annema, Jouke T.

doi:10.1016/j.lungcan.2008.04.004

Cited by 137 publications

(107 citation statements)

References 25 publications

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“…Approximately one-third of primary NSCLC diagnoses are performed on cytological samples (62)(63)(64) and usually no other biopsy materials are available for molecular analyses. Efforts have therefore been focused on detection of EGFR mutations in cytological samples and the results of several studies have demonstrated that cytological material is suitable and reliable for EGFR mutation analysis (65)(66)(67)(68)(69)(70), such as that for the EML4-ALK FISH test (68).…”

Section: Biological Samples Suitable For Molecular Characterisationmentioning

confidence: 99%

Target therapy in NSCLC patients: Relevant clinical agents and tumour molecular characterisation

Ulivi

Zoli

Capelli

et al. 2013

Molecular and Clinical Oncology

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Abstract. In recent years, a number of new agents that target specific molecular pathways in non-small cell lung cancer (NSCLC) have been investigated. Much effort has been focused on identifying specific markers that are predictive of treatment response, given that a tailored approach would maximise the therapeutic index and cost-effectiveness. Gefitinib and erlotinib are selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) and have produced good results in selected cases in terms of objective response rate and overall survival. At present, EGFR gene mutations are considered the most important predictors of clinical response to TKI therapy and tumour characterisation for these alterations is mandatory prior to any decision making. Echinoderm microtubule-like protein 4-anaplastic lymphoma kinase (EML4-ALK) translocation is another alteration capable of predicting the efficacy of anti-ALK agents, such as crizotinib. Moreover, emerging target agents, such as MET inhibitors, are likely to increase the amount of molecular characterisation required before a decision is made on treatment. The main limiting factor for adequate characterisation of metastatic NSCLC patients is the small quantity of tumour cells available for molecular analysis. In this study, we provided an overview of the most important and clinically relevant target agents in NSCLC patients as well as the most important mechanisms of resistance. The issue of the scant amount of biological samples available for analysis as well as alternative sampling approaches such as plasma-or serum-derived DNA were also examined.

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Section: Biological Samples Suitable For Molecular Characterisationmentioning

confidence: 99%

Target therapy in NSCLC patients: Relevant clinical agents and tumour molecular characterisation

Ulivi

Zoli

Capelli

et al. 2013

Molecular and Clinical Oncology

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“…Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive well-established technique for mediastinal and hilar lymph node or mass diagnosis [1][2][3] and for lung cancer staging [4] that allows a tissue sampling more accurate than blind transbronchial needle aspiration (TBNA) [5].…”

Section: Introductionmentioning

confidence: 99%

Endobronchial ultrasound-guided transbronchial needle aspiration under conscious sedation with meperidine and midazolam

Agostini¹,

Facciolongo²,

Lusuardi

et al. 2017

Monaldi Arch Chest Dis

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Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under general anesthesia or deep sedation with drugs such as Propofol that, at least in Italy, can be administered only by an anesthesiologist. Aim of the study was to assess conscious sedation feasibility, safety and tolerability using meperidine and midazolam as administered by Pulmonologist and relevant impact on the efficiency of the sampling procedures.All patients undergoing EBUS-TBNA from February 2013 to July 2014 were examined retrospectively. Efficiency using Meperidine and Midazolam during EBUS-TBNA has been assessed: completion of lymphnodal sampling, sampling adequacy, diagnostic yield, cough during endoscopic procedure complications and need for procedure repetition with Anesthesiology assistance. Patient satisfaction and cost/effectiveness were also evaluated. One hundred and thirty-four consecutive patients were considered; 97.7% completed the procedure. In 96.9% of cases the prefixed program of lymph-nodal sampling was accomplished. Sampling adequacy was 92,4%. Diagnostic yield was 55%. In 94.7% of cases cough was absent or did not interfere with EBUS-TBNA. The need to repeat the endoscopic procedure occurred in 6 cases but only in 2 the presence of an Anesthesiologist was required. Patient satisfaction was very high, with 95.9% of subjects reporting they would "definitely return". A 27% cost reduction was calculated. EBUS-TBNA under conscious sedation using Meperidine and Midazolam prescribed and administered by pulmonologist without the Anesthesiologist assistance, revealed to be a safe, well tolerated and cost saving procedure. The efficiency of sampling was good, apart from a relatively low diagnostic yield due to different expertise of operators.

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“…Tournoy et al suggested that negative EBUS-TBNA results should be confirmed by other diagnostic methods. 30 In accordance with this point of view, one of our lung cancer patients with nonmalignant mediastinal lymph nodes which biopsy was taken with EBUS-TBNA was accepted as malignant after mediastinoscopy.…”

Section: Discussionmentioning

confidence: 88%

“…The results in the literature also support this finding. [30][31][32] EBUS-TBNA is accepted as a quite reliable diagnostic procedure without serious complications. 7,10,12,32 Rarely, cough, bleeding in the application point of needle and clinically unimportant infections were reported as complications.…”

Section: Discussionmentioning

confidence: 99%

Role of Real-Time Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Diagnosis and Mediastinal Staging of Lung Cancer

Alataş¹,

Dündar²,

Yıldırım³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive new diagnostic tool used for diagnosis and mediastinal staging of lung cancer. The aim of this study is to evaluate the role of real-time EBUS-TBNA for diagnosis of lymph nodes in patients with suspected lung cancer who had mediastinal and/or hilar lymph nodes. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Between April 2009 and January 2011, 52 patients with mediastinal and/or hilar lymphadenopathy suspected for lung cancer referred for TBNA were enrolled in the study. R Re es su ul lt ts s: : Of 97 lymph node biopsy specimens, 94 were eligible for diagnosis. Of three patients with malignancy negative lymph node biopsy specimens, two gave their consents and underwent mediastinoscopy. The result of one patient was negative, and the other one was positive for malignancy. The third patient was accepted to have a non malignant disease since the positron emission tomography of lymph node was negative for malignancy and remained stable and non-malignant during the follow-up. The sensitivity and specificity of EBUS-TBNA in the diagnostic evaluation of mediastinal and/or hilar lymph nodes of patients with suspected for lung cancer were 98.9% and 100%, respectively. Twelve N3 lymph nodes were diagnosed as positive for malignancy. Twenty three patients without endobronchial lesions on conventional bronchoscopy were diagnosed as lung cancer by real-time EBUS-TBNA. No complications were recorded during the procedures. C Co on nc cl lu us si io on n: : Real-time EBUS-TBNA is an effective and reliable diagnostic procedure. Moreover, it is a very useful tool for diagnosis of lesions which cannot be reached with the conventional bronchoscope.K Ke ey y W Wo or rd ds s: : Lung neoplasms; lymph nodes; diagnosis Ö ÖZ ZE ET T A Am ma aç ç: : Eş zamanlı endobronşiyal ultrason kılavuzlu transbronşiyal iğne aspirasyonu (EBUS-TBNA) akciğer kanserinin teşhisi ve mediastinal evrelemesi için kullanılıp minimal invaziv olan yeni bir teşhis yöntemidir. Bu çalışmanın amacı akciğer kanseri olarak şüphelenilen ve mediastinal ve/veya hiler lenf nodları olan hastalarda lenf nodlarının teşhisi için eş zamanlı EBUS-TBNA'nın rolünü değerlendirmektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Nisan 2010-Ocak 2011 arasında akciğer kanseri şüphesi ve mediastinal ve/veya hiler lenf nodları nedeniyle transbronşial biyopsi önerilen 52 hasta çalışmaya alındı. B Bu ul lg gu ul la ar r: : Doksan yedi lenf nodu biyopsi örneğinden 94'ü teşhis için uygundu. Lenf nodu biyopsi örneği malignite negatif olarak raporlanan üç hastanın ikisine rıza göstermeleri üzerine mediastinoskopi uygulandı. Bunlardan biri malignite pozitifti. Üçüncü hasta lenf nodunun pozitron emisyon tomografisinin malignensi için negatif olmasından dolayı non-malign olarak kabul edildi ve takip boyunca stabil ve non-malign olarak kaldı. Akciğer kanseri için şüphelenilen hastaların mediastinal ve/veya hil...

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EBUS-TBNA for the diagnosis of central parenchymal lung lesions not visible at routine bronchoscopy

Cited by 137 publications

References 25 publications

Target therapy in NSCLC patients: Relevant clinical agents and tumour molecular characterisation

Target therapy in NSCLC patients: Relevant clinical agents and tumour molecular characterisation

Endobronchial ultrasound-guided transbronchial needle aspiration under conscious sedation with meperidine and midazolam

Role of Real-Time Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Diagnosis and Mediastinal Staging of Lung Cancer

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