Evaluating Yield of 19 Versus 21 G EBUS-TBNA Needles

Elmufdi, Firas; Peterson, Marissa; Niccum, David; Asche, Stephen E.; Ham, Kealy

doi:10.1097/lbr.0000000000000674

Cited by 12 publications

(10 citation statements)

References 13 publications

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“…However, in several cases this is not possible even with 19G needles. In the study by Elmufdi FS et al [18], there was no difference in the overall diagnostic yield between 19 and 21 G needles. Further studies are needed to confirm the trend of the superiority of 19 G in cancerous lymph node.…”

Section: Discussionmentioning

confidence: 81%

“…However, this should be another study evolving other types of cancer such as lymphoma because 19G is mostly used when there is a suspicion of such case [17]. However; we should mention that in the study by Lim CE et al [17] and Elmufdi FS et al [18] when the 22G was compared to 19G needle the results were similar for the diagnosis of lymphoma. Therefore, we should always keep in mind that the EBUS operator must have a pathology department with sufficient experience.…”

Section: Methodsmentioning

confidence: 86%

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Lung cancer biopsies: Comparison between simple 22G, 22G upgraded and 21G needle for EBUS-TBNA

et al. 2020

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Introduction: Novel technologies are currently used for lung cancer diagnosis. EBUS-TBNA 22G is considered one of the most important tools. However; there are still issues with the sample size. Patients and Methods: 223 patients underwent EBUS-TBNA with a 21G Olympus needle, 22GUS Mediglobe and 22GUB Mediglobe. In order to evaluate the efficiency of 22GUB novel needle design. In order to evaluate the sample size of each needle, we constructed cell blocks and measured the different number of slices from each biopsy site. Results: The 22GUB novel needle had similar and larger number of slices from each biopsy site compared to 21G needle. Discussion: Firstly as a novel methodology we used the number of slices from the constructed cell blocks in order to evaluate the sample size. Secondly, we should seek novel needle designs and not only concentrate on the volume of the sample size.

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Section: Discussionmentioning

confidence: 81%

Section: Methodsmentioning

confidence: 86%

Lung cancer biopsies: Comparison between simple 22G, 22G upgraded and 21G needle for EBUS-TBNA

et al. 2020

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“…Prospective series obtained equivalent diagnostic yields with different needle gauges [ 9 , 10 ]. However, the actual ability of the 19-G flex needle to provide larger tissue samples and the number of cells obtained when sampling with different needle gauges have never been addressed.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Performance and Cell Count of EBUS–TBNA Needle Gauges: A Prospective Trial

Guarize

Diotti

Casiraghi

et al. 2023

JCM

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Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well-established diagnostic procedure for evaluating hilar and mediastinal lymphadenopathies and is the gold standard for lung cancer diagnosis and staging. Recent studies assessed the effectiveness of the 19-G flex needle in obtaining larger EBUS-TBNA samples, and prospective small series gave similar results in terms of diagnostic yield when testing different gauge needles. The lack of homogeneity between series and the small sample size of some prospective cohorts poses a limit to the validity of those results. This prospective controlled study compared the 19-G flex and 22-G needles in terms of diagnostic yield. An objective laboratory method was used to count cells and compare the two needles’ cytologic yields. Material. A prospective controlled study was conducted on 90 patients undergoing EBUS-TBNA for the diagnosis of hilar and mediastinal lymphadenopathies. The institutional ethic committee (IEO573) approved the study, and informed consent was obtained from all patients. Results. A total of 90 patients were enrolled in this study, 84.4% of whom were diagnosed with malignancy and 15.6% with non-neoplastic disease. Sensitivity for malignancy was 93.4% (CI: 87.4–97.1%) for the 19-G needle and 92.6% (CI: 86.3–96.5%) for the 22-G needle (p = 0.80). The percentage of malignant cells in the cell block was 63.9% and 61.5% for the 22-G and 19-G needles, respectively. The cell count assessed by flow cytometry was 2071 cells/µL (IQR: 600,2265) with the 22-G needle and 2761 cells/µL (IQR: 505,3250) with the 19-G needle (p = 0.79). The malignant cell count was 0.05 × 103 cells/µL with the 22-G and 0.08 × 103 cells/µL with the 19-G needle (p = 0.70). There was no difference in the presence of tissue cores in the samples, and rapid on-site evaluation (ROSE) cellularity was comparable between the two needles. Conclusions. The 19-G flex EBUS-TBNA needle is comparable to the 22-G needle in terms of diagnostic yield for cyto-histological evaluation of hilar and mediastinal lymphadenopathies. There is no difference between the 19-G and 22-G needle cell counts evaluated by flow cytometry.

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“…Comparisons between 21G and 25G [76] and 19G and 21G [77] needles have demonstrated similar yields, including for NSCLC diagnosis. However, these studies did not compare differences in the quality of biomarker testing between these needles.…”

Section: Needle Size and Other Sampling Toolsmentioning

confidence: 90%

Lung cancer staging, the established role of bronchoscopy

Marshall

Kalanjeri

Almeida

2021

Current Opinion in Pulmonary Medicine

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Purpose of reviewLung cancer is the leading cause of cancer-related deaths worldwide. In the absence of distant metastases, accurate mediastinal nodal staging determines treatment approaches to achieve most favourable outcomes for patients. Mediastinal staging differentiates N0/N1 disease from N2/N3 in surgical candidates. Likewise, presence of nodal involvement in nonsurgical candidates who are being considered for stereotactic body radiation therapy is also critical. This review article seeks to discuss the current options available for mediastinal staging in nonsmall cell lung cancer (NSCLC), particularly the role of bronchoscopy. Recent findingsAlthough several techniques are available to stage the mediastinum, bronchoscopy with EBUS-TBNA with or without EUS-FNA appears to be superior in most clinical situations based on its ability to concomitantly diagnose and stage at once, safety, accessibility to the widest array of lymph node stations, cost and low risk of complications. However, training and experience are required to achieve consistent diagnostic accuracy with EBUS-TBNA. SummaryEBUS-TBNA with or without EUS-FNA is considered the modality of choice in the diagnosis and staging of NSCLC in both surgical and nonsurgical candidates.

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Evaluating Yield of 19 Versus 21 G EBUS-TBNA Needles

Cited by 12 publications

References 13 publications

Lung cancer biopsies: Comparison between simple 22G, 22G upgraded and 21G needle for EBUS-TBNA

Lung cancer biopsies: Comparison between simple 22G, 22G upgraded and 21G needle for EBUS-TBNA

Diagnostic Performance and Cell Count of EBUS–TBNA Needle Gauges: A Prospective Trial

Lung cancer staging, the established role of bronchoscopy

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