Endobronchial ultrasound bronchoscopy: current uses, innovations and future directions

Warren, Whittney; Sobieszczyk, Michal J.; Sarkar, Sy; Krimsky, William

doi:10.21037/amj.2018.06.06

Cited by 6 publications

(4 citation statements)

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“…Although EBUS is most frequently used in the diagnosis and staging of lung cancer, it has also have an important role in the differential diagnosis of IMHL. 4,5,17,18 In the REMEDY trial, where the efficiency of EBUS-TBNA was evaluated as an alternative to mediastinoscopy in IMHL patients, 4 the sensitivity and diagnostic efficiency of the procedure were determined as 92%, and the NPV was determined as 40%.…”

Section: Discussionmentioning

confidence: 99%

The role of endobronchial ultrasound‐guided transbronchial needle aspiration in the differential diagnosis of isolated mediastinal and/or hilar lymphadenopathy

Temiz

İn

Kuluöztürk

et al. 2021

Diagnostic Cytopathology

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Introduction Isolated mediastinal and/or hilar lymphadenopathy (IMHL) has become an increasingly common finding as a result of the increased use of thoracic imaging modalities. Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is accepted as the first step diagnostic method in the differential diagnosis of IMHL. Objective To determine the diagnostic yield of the procedure and to analyze clinical and sonographic findings that can be used to differentiate the etiology of lymph node pathologies. Methods Patients who underwent EBUS‐TBNA procedure between March 2017 and March 2020 were included in this retrospective study. Demographic data, symptoms, comorbid diseases, and EBUS findings were obtained from the records of the patients. Results EBUS‐TBNA provided a diagnosis in 88 patients out of 120 patients (granulomatous diseases n = 54, malignant diseases n = 21, and anthracotic lymph nodes n = 13), and 32 patients had a negative EBUS‐TBNA. 22/32 negative EBUS‐TBNA samples were true negatives (reactive lymphadenopathy). The sensitivity of the procedure was 89.8% while negative predict value was 68.7%, diagnostic yield of 91.6%. Patients with reactive lymph nodes had significantly more comorbidities (77.3%–19.4%, p < .001) and a lower number of lymph node stations (1.6 ± 0.8–2.7 ± 0.9, p < .001). Patients with anthracotic lymph nodes were older and mostly consisted of females (11/13, p < .001). Conclusion EBUS‐TBNA has high‐diagnostic efficiency in the differential diagnosis of IMHL. The number and size of lymph node stations can provide useful information for differential diagnosis. Clinical follow‐up can be a more beneficial approach in patients with reactive and anthracotic lymph nodes before invasive sampling.

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Section: Discussionmentioning

confidence: 99%

The role of endobronchial ultrasound‐guided transbronchial needle aspiration in the differential diagnosis of isolated mediastinal and/or hilar lymphadenopathy

Temiz

İn

Kuluöztürk

et al. 2021

Diagnostic Cytopathology

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“…Peripheral lung nodules, which previously were deemed not amenable to EBUS are becoming increasingly accessible via new technology. Electromagnetic navigational bronchoscopy with cone beam CT scan in conjunction with EBUS has been successfully used to biopsy peripheral or difficult to access pulmonary nodules ( 70 ). Additionally, the iNod system (Boston Scientific, Watertown, MA) allows for real-time biopsy of peripheral nodules under radial EBUS visualization.…”

Section: Future Directionsmentioning

confidence: 99%

Narrative review of tools for endoscopic ultrasound-guided biopsy of mediastinal nodes

Yang¹,

Cardenas²,

Nobari³

et al. 2020

Mediastinum

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Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) has revolutionized the diagnosis and staging of lung cancer. Multiple studies support EBUS as a safe, cost-effective, and accurate method of diagnosing lung cancer. Even with the groundbreaking developments of immunotherapy and targeted therapy in advanced non-small cell lung cancer, EBUS-TBNA remains the optimal method for obtaining tissue for molecular testing. Since the advent of EBUS, there have been a multitude of needles and biopsy tools that have been developed, each with its own unique features that may make it suitable for various clinical situations. With needle sizes ranging from 19 gauge to 25 gauge, and both aspiration and biopsy needles, as well as mini-forceps available, there are now numerous tools to choose from. Over the past several years, EBUS has also gained new roles outside the realm of lung malignancy. EBUS now plays an important role in diagnosing other thoracic pathology, such as sarcoidosis and lymphoma, as well as facilitating treatment of both benign and malignant disease. As the use of EBUS has become more widespread, new tools have emerged to allow for EBUS to continue expanding its applicability. This review examines the evidence for the current equipment and novel tools that are being used in EBUS-guided biopsy.

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“…1 After using a chest computed tomography (CT) scan to identify suspect PPLs, physicians perform bronchoscopy with the aim of acquiring a lesion biopsy. 2,3 During such a procedure, the physician first navigates the bronchoscope to the correct airway and uses radial probe endobronchial ultrasound (RP-EBUS) to confirm the lesion's location. 4 After confirming the lesion's location, the physician then biopsies the site.…”

Section: Introductionmentioning

confidence: 99%

Automatic procedure planning for radial-probe endobronchial ultrasound

Kao,

Higgins

2024

Medical Imaging 2024: Image-Guided Procedures, Robotic Interventions, and Modeling

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The examination of suspicious peripheral pulmonary lesions (PPLs) is an important part of lung cancer diagnosis. The physician performs bronchoscopy and then employs radial-probe endobronchial ultrasound (RP-EBUS) to examine and biopsy suspect lesions. Physician skill, however, plays a significant part in the success of these procedures. This has driven the introduction of image-guided bronchoscopy systems. Yet, while such systems enable route planning through the airways to reach a desired region of interest (ROI), the route does not come with the appropriate device maneuvers crucial for instructing the physician on how to use the bronchoscope and the R-EBUS probe during the procedure. Our recently proposed image-guided bronchoscopy system, the Multimodal Virtual Navigation System (MVNS), does offer such instructions for the devices involved. Unfortunately, the system relies on a time-consuming, error-prone, manual approach to generate these device maneuvers. We propose an automatic approach for creating a complete set of device maneuvers for both the bronchoscope and the R-EBUS probe, fully integrating it into the MVNS in the process. Results show that planning the device maneuvers, which previously took on the order of 5 minutes or more per ROI, is reduced to under one second.

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Endobronchial ultrasound bronchoscopy: current uses, innovations and future directions

Cited by 6 publications

References 0 publications

The role of endobronchial ultrasound‐guided transbronchial needle aspiration in the differential diagnosis of isolated mediastinal and/or hilar lymphadenopathy

The role of endobronchial ultrasound‐guided transbronchial needle aspiration in the differential diagnosis of isolated mediastinal and/or hilar lymphadenopathy

Narrative review of tools for endoscopic ultrasound-guided biopsy of mediastinal nodes

Automatic procedure planning for radial-probe endobronchial ultrasound

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