Randomized Clinical Trial of Endobronchial Ultrasound Needle Biopsy With and Without Aspiration

Casal, Roberto F.; Staerkel, Gregg; Ost, David; Almeida, Francisco A.; Uzbeck, Mateen; Eapen, Georgie A.; Jiménez, Carlos A.; Nogueras‐González, Graciela M.; Sarkiss, Mona; Morice, Rodolfo C.

doi:10.1378/chest.11-0692

Cited by 71 publications

(83 citation statements)

References 6 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A prospective trial conducted by Casal et al [27] compared EBUS-TBNA with EBUS biopsy without aspiration, referring to the latter as ‘transbronchial needle capillary sampling' (TBNCS). Both techniques were employed in each LN, and the order in which they were performed was randomized to avoid the ‘first-pass' effect.…”

Section: Results Of Pico Questionmentioning

confidence: 99%

Guideline for the Acquisition and Preparation of Conventional and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Specimens for the Diagnosis and Molecular Testing of Patients with Known or Suspected Lung Cancer

et al. 2014

Self Cite

View full text Add to dashboard Cite

Rationale: Conventional transbronchial needle aspiration (TBNA) and endobronchial ultrasound (EBUS)-TBNA are widely accepted tools for the diagnosis and staging of lung cancer and the initial procedure of choice for staging. Obtaining adequate specimens is key to provide a specific histologic and molecular diagnosis of lung cancer. Objectives: To develop practice guidelines on the acquisition and preparation of conventional TBNA and EBUS-TBNA specimens for the diagnosis and molecular testing of (suspected) lung cancer. We hope to improve the global unification of procedure standards, maximize the yield and identify areas for research. Methods: Systematic electronic database searches were conducted to identify relevant studies for inclusion in the guideline [PubMed and the Cochrane Library (including the Cochrane Database of Systematic Reviews)]. Main Results: The number of needle aspirations with both conventional TBNA and EBUS-TBNA was found to impact the diagnostic yield, with at least 3 passes needed for optimal performance. Neither needle gauge nor the use of miniforceps, the use of suction or the type of sedation/anesthesia has been found to improve the diagnostic yield for lung cancer. The use of rapid on-site cytology examination does not increase the diagnostic yield. Molecular analysis (i.e. EGFR, KRAS and ALK) can be routinely performed on the majority of cytological samples obtained by EBUS-TBNA and conventional TBNA. There does not appear to be a superior method for specimen preparation (i.e. slide staining, cell blocks or core tissue). It is likely that optimal specimen preparation may vary between institutions depending on the expertise of pathology colleagues.

show abstract

Section: Results Of Pico Questionmentioning

confidence: 99%

Guideline for the Acquisition and Preparation of Conventional and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Specimens for the Diagnosis and Molecular Testing of Patients with Known or Suspected Lung Cancer

et al. 2014

Self Cite

View full text Add to dashboard Cite

show abstract

“…Lymph nodes of interest are identified by the puncturescope, and a flexible 21-gague or 22-gague needle is passed through the 2-mm instrument channel and then thrust 15-20 times within the lymph node under real-time ultrasound visualisation. Lymph node contents can be aspirated by suction with a syringe [62]. After withdrawal a stylet is inserted through the needle to evacuate residual tissue.…”

Section: Discussionmentioning

confidence: 99%

ERS statement: interventional bronchoscopy in children

et al. 2017

View full text Add to dashboard Cite

Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives. There is a scarcity of published evidence in this field, and in many cases the task force had to resort to the collective clinical experience of the committee to develop this statement. The highlighted gaps in knowledge underline the need for further research and serve as a call to paediatric bronchoscopists to work together in multicentre collaborations, for the benefit of children with airway disorders.

show abstract

“…In the context of potentially operable NSCLC, for thorough assessment of mediastinal node involvement it is generally agreed that 3 needle passes per target LN should be obtained, if rapid on-site evaluation (ROSE) of samples is not used (17)(18)(19)(20). Each pass should include 5 to 15 needle agitations within the target node (18), with or without suction (21). The important indication that three is the optimal number of punctures per target LN was provided by the study of Lee et al who evaluated by EBUS-TBNA 163 LN stations in 102 NSCLC patients (19).…”

Section: Sample Acquisition and Preparation Techniquesmentioning

confidence: 99%

Endobronchial ultrasound-transbronchial needle aspiration for mediastinal staging of non-small cell lung cancer: variability of results and perspectives

2017

View full text Add to dashboard Cite

The remarkable value of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for mediastinal staging of non-small cell lung cancer (NSCLC) is recognized worldwide.Reports from different centers however show considerable variation of EBUS-TBNA performance in terms of diagnostic yield, sensitivity and negative predictive value (NPV). Interpretation of EBUS-TBNA diagnostic efficacy requires clarifying whether the technique is used for purely diagnostic purpose or mediastinal staging, recognizing that different study groups may be inherently heterogeneous and that numerous factors may impact on the procedure outcomes. Review of these factors indicates that the prevalence of N2/N3 disease, the thoroughness of mediastinal sampling and >3 needle passes per target lymph node (LN) [in the absence of rapid on-site evaluation (ROSE)] influence the procedure outcomes, while many details in the sample preparation technique are unlikely to impact on the results and should be left to the proceduralists' preference. Generalized use of a standardized database for prospective collection of relevant EBUS-TBNA data would allow reporting institutional results by subgroups of N2/N3 disease prevalence and thoroughness of staging, and would help establishing quality standards for the procedure.

show abstract

Randomized Clinical Trial of Endobronchial Ultrasound Needle Biopsy With and Without Aspiration

Abstract: ClinicalTrials.gov; No.: NCT00886847; URL: www.clinicaltrials.gov

Cited by 71 publications

References 6 publications

Guideline for the Acquisition and Preparation of Conventional and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Specimens for the Diagnosis and Molecular Testing of Patients with Known or Suspected Lung Cancer

Guideline for the Acquisition and Preparation of Conventional and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Specimens for the Diagnosis and Molecular Testing of Patients with Known or Suspected Lung Cancer

ERS statement: interventional bronchoscopy in children

Endobronchial ultrasound-transbronchial needle aspiration for mediastinal staging of non-small cell lung cancer: variability of results and perspectives

Contact Info

Product

Resources

About