MP-17.12

Rivera, Rolando; Barboglio, Paholo; Hellinger, Michael D.; Gousse, Angelo E.

doi:10.1016/j.urology.2006.08.525

Cited by 20 publications

(31 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…First, the pooled diagnostic yield of 70% is much higher than yields reported previously using traditional bronchoscopic techniques. 5,6 Second, although the diagnostic yield for guided bronchoscopic techniques is lower than that reported for TTNA, the adverse event rate is also signifi cantly lower. Third, the yield is dependent on the size of the lesion.…”

Section: Discussionmentioning

confidence: 94%

“…When biopsy is recommended, transthoracic needle aspiration (TTNA) is currently preferred because it has a diagnostic yield of 90%; however, TTNA also has a pneumothorax rate of about 25%, of which at least 15% requires chest tube insertion (overall chest tube rate of 5%). 4,5 Flexible bronchoscopy is another diagnostic option, but the sensitivity of traditional transbronchial biopsy ranges from 14% to 63%, depending on the size and location of the PN. 5,6 Bronchoscopy with guidance has evolved as a viable option "if the operator has expertise in newer guided techniques."…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Flexible bronchoscopy is another diagnostic option, but the sensitivity of traditional transbronchial biopsy ranges from 14% to 63%, depending on the size and location of the PN. 5,6 Bronchoscopy with guidance has evolved as a viable option "if the operator has expertise in newer guided techniques." 4 Within the past decade, new techniques have emerged that offer guidance through the tracheobronchial tree during bronchoscopy to help reach and biopsy PN.…”

Section: Discussionmentioning

confidence: 99%

“…4,48 TTNA does have a 90% chance of confi rming a diagnosis (range, 76% to 90%), but some report a pneumothorax rate as high as 40%. 4,5,[49][50][51][52][53][54][55][56][57] Additionally, the diagnostic yield is infl uenced by the size of the lesion, the size of the needle, the number of passes, and the presence of rapid on-site evaluation. 4,5,[53][54][55][56] The location of the lesion in the lungs, peripheral vs central, may also infl uence the diagnostic yield of TTNA.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Meta-analysis of Guided Bronchoscopy for the Evaluation of the Pulmonary Nodule

Memoli

Nietert

Silvestri

2012

Chest

545

496

View full text Add to dashboard Cite

385 PULMONARY PROCEDURESsuspicious for lung cancer. 2 With the fi ndings of the NLST indicating a reduction in lung-cancer-specifi c mortality with CT scanning in at-risk people, the number of patients diagnosed with a PN could increase substantially if screening for lung cancer is broadly T he pulmonary nodule (PN) is becoming an increasingly common radiographic fi nding among patients in the United States. Nearly 45 million CT scan examinations are performed each year, and 11% to 30% (4.5-14 million) of those include an examination of the chest. 1 In the recently released National Cancer Institute-sponsored National Lung Screening Trial (NLST), . 25% of the group who underwent lowdose CT scans of the chest had examinations that were Background: The detection of pulmonary nodules (PNs) is likely to increase, especially with the release of the National Lung Screen Trials. When tissue diagnosis is desired, transthoracic needle aspiration (TTNA) is recommended. Several guided-bronchoscopy technologies have been developed to improve the yield of transbronchial biopsy for PN diagnosis: electromagnetic navigation bronchoscopy (ENB ), virtual bronchoscopy (VB), radial endobronchial ultrasound (R-EBUS), ultrathin bronchoscope, and guide sheath. We undertook this meta-analysis to determine the overall diagnostic yield of guided bronchoscopy using one or a combination of the modalities described here. Methods: We performed a MEDLINE search using "bronchoscopy" and "solitary pulmonary nodule." Studies evaluating the diagnostic yield of ENB, VB, R-EBUS, ultrathin bronchoscope, and/or guide sheath for peripheral nodules were included. The overall diagnostic yield and yield based on size were extracted. Adverse events, if reported, were recorded. Meta-analysis techniques incorporating inverse variance weighting and a random-effects meta-analysis approach were used. Results: A total of 3,052 lesions from 39 studies were included. The pooled diagnostic yield was 70%, which is higher than the yield for traditional transbronchial biopsy. The yield increased as the lesion size increased. The pneumothorax rate was 1.5%, which is signifi cantly smaller than that reported for TTNA. Conclusion: This meta-analysis shows that the diagnostic yield of guided bronchoscopic techniques is better than that of traditional transbronchial biopsy. Although the yield remains lower than that of TTNA, the procedural risk is lower. Guided bronchoscopy may be an alternative or be complementary to TTNA for tissue sampling of PN, but further study is needed to determine its role in the evaluation of peripheral pulmonary lesions.CHEST 2012; 142(2):385-393Abbreviations: ENB 5 electromagnetic navigation bronchoscopy; NLST 5 National Lung Screening Trial; PN 5 pulmonary nodule; R-EBUS 5 radial endobronchial ultrasound; TTNA 5 transthoracic needle aspiration; VB 5 virtual bronchoscopy

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Meta-analysis of Guided Bronchoscopy for the Evaluation of the Pulmonary Nodule

Memoli

Nietert

Silvestri

2012

Chest

545

496

View full text Add to dashboard Cite

show abstract

“…Although the former procedure has relatively high diagnostic sensitivity and specificity (2), it has disadvantages of a high rate of pneumothorax (15-43%, with 4-18% requiring drainage) and a high risk of bleeding (1-27%) (3,4). TBB under X-ray fluoroscopy has a relatively low diagnostic rate and is no longer recommended (5). In 2002, the diagnosis of PPLs with radial probe endobronchial ultrasound (rEBUS) was reported with a diagnostic rate of 80% (6).…”

Section: Introductionmentioning

confidence: 99%

Radial endobronchial ultrasonography with distance measurement through a thin bronchoscope for the diagnosis of malignant peripheral pulmonary lesions

Zhang

Zhou

et al. 2018

Transl. Lung Cancer Res.

View full text Add to dashboard Cite

Background: Peripheral pulmonary lesions (PPLs) are being discovered more frequently. We investigated efficiency, safety, and influencing factors in radial probe endobronchial ultrasound with distance measurement (rEBUS-D) using a thin bronchoscope during transbronchial biopsy (TBB) for the diagnosis of malignant PPLs. Methods:Patients with PPLs who underwent rEBUS were retrospectively analyzed. Cases with rEBUS-D and a gold-standard final diagnosis were considered.Results: rEBUS was completed in 589 cases; 328 were analyzed. The lesion discovery rate was 85.06%; the overall rEBUS-D-TBB diagnostic rate was 54.88%. There were 193 cases of malignant tumors. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of rEBUS-D-TBB in the diagnosis of malignant PPLs were 63.73%, 100%, 100%, 65.85%, and 78.40%, respectively.Single-and multi-factor analyses showed that lesion size, ultrasound probe position, and a positive bronchus sign on thoracic computed tomography (CT) were significant factors influencing diagnosis (all P=0.000); probe position and the bronchus sign were independent influencing factors. The effect of lesion distribution on diagnosis was not significant. In seven cases, postoperative pathology showed mixed tumors. Two cases of malignant tumors were combined with benign pathology; rEBUS-D-TBB did not suggest two pathologies. Thirteen cases had 50-100 mL of blood loss (3.96%); no pneumothorax or infection was observed.Conclusions: rEBUS-D-TBB had high sensitivity, 100% specificity, excellent safety, and a lower cost than rEBUS-GS-TBB in the diagnosis of malignant PPLs. Larger lesions, a positive bronchus sign on CT, and ultrasound probe position at the lesion's center yielded higher diagnostic rates.

show abstract

Management of Rectourethral Fistula

Saund

Bleday

2012

Reconstructive Surgery of the Rectum, Anus and Perineum

View full text Add to dashboard Cite

MP-17.12

Cited by 20 publications

References 0 publications

Meta-analysis of Guided Bronchoscopy for the Evaluation of the Pulmonary Nodule

Meta-analysis of Guided Bronchoscopy for the Evaluation of the Pulmonary Nodule

Radial endobronchial ultrasonography with distance measurement through a thin bronchoscope for the diagnosis of malignant peripheral pulmonary lesions

Management of Rectourethral Fistula

Contact Info

Product

Resources

About