Rapid on-site cytologic evaluation by pulmonologist improved diagnostic accuracy of endobronchial ultrasound-guided transbronchial biopsy

Lin, Cheng Hsin; Jan, I-Shiow; Yu, Kai-Lun; Chang, Li-Chien; Fan, Hung-Jen; Wen, Yueh-Feng; Ho, Chao‐Chi

doi:10.1016/j.jfma.2020.01.001

Cited by 17 publications

(13 citation statements)

References 33 publications

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“…In the present study, there was no significant difference in the diagnostic yield in the subgroup analysis ( Table 5 ). These results are very similar to that of our previous publication [ 8 ]. By including ROSE in the procedure, the diagnostic yield of EBUS-TBB was not only improved, but the effect of the factors mentioned above was reduced.…”

Section: Discussionsupporting

confidence: 93%

“…Radial-EBUS plays an important role in the “confirmation” step, by verifying contact with the target through its real-time imaging. ROSE provides immediate feedback to ensure proper samples for morphological analysis, thereby implementing the “acquisition” step [ 8 , 20 ]. For the “navigation” step, virtual bronchoscopic navigation or electromagnetic navigation have been considered to be traditional guiding tools in bronchoscopic techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Endobronchial ultrasound-guided transbronchial biopsy (EBUS-TBB) is now widely used for the diagnosis of PPLs [ 3 , 4 , 5 ]. In previous publications, the diagnostic accuracy of EBUS-TBB alone has ranged from 60–70% [ 6 , 7 , 8 ]. Combined use with other methods, such as fluoroscopy or virtual bronchoscopic navigation, has been attempted to improve diagnostic accuracy [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Cone-Beam Computed Tomography-Derived Augmented Fluoroscopy Improves the Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Biopsy for Peripheral Pulmonary Lesions

et al. 2021

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Background: Endobronchial ultrasound-guided transbronchial biopsy (EBUS-TBB) is used for the diagnosis of peripheral pulmonary lesions (PPLs), but the diagnostic yield is not adequate. Cone-beam computed tomography-derived augmented fluoroscopy (CBCT-AF) can be utilized to assess the location of PPLs and biopsy devices, and has the potential to improve the diagnostic accuracy of bronchoscopic techniques. The purpose of this study was to verify the contribution of CBCT-AF to EBUS-TBB. Methods: Patients who underwent EBUS-TBB for diagnosis of PPLs were enrolled. The navigation success rate and diagnostic yield were used to evaluate the effectiveness of CBCT-AF in EBUS-TBB. Results: In this study, 236 patients who underwent EBUS-TBB for PPL diagnosis were enrolled. One hundred fifteen patients were in CBCT-AF group and 121 were in non-AF group. The navigation success rate was significantly higher in the CBCT-AF group (96.5% vs. 86.8%, p = 0.006). The diagnostic yield was even better in the CBCT-AF group when the target lesion was small in size (68.8% vs. 0%, p = 0.026 for lesions ≤10 mm and 77.5% vs. 46.4%, p = 0.016 for lesions 10–20 mm, respectively). The diagnostic yield of the two study groups became similar when the procedures with a failure of navigation were excluded. The procedure-related complication rate was similar between the two study groups. Conclusion: CBCT-AF is safe, and effectively enhances the navigation success rate, thereby increasing the diagnostic yield of EBUS-TBB for PPLs.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cone-Beam Computed Tomography-Derived Augmented Fluoroscopy Improves the Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Biopsy for Peripheral Pulmonary Lesions

et al. 2021

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“…A randomized trial performed by Mondoni et al 12 showed that ROSE method increased the cytological diagnostic sensitivity of TBLB from 76-97%. Lin et al 13 collected information from 336 patients undergoing EBUS-TBB surgery, and the application of ROSE method signi cantly improved diagnostic accuracy compared with EBUS-TBB without ROSE (88.4% vs. 68.0%, P < 0.001). Another study 14 showed a better diagnostic yield from 89.2% without ROSE to 92.1% with ROSE in sampling hilar-mediastinal lymphadenopathies in lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Value of Transbronchial Needle Aspiration Combined with Rapid on-Site Evaluation of Cytology in Diagnosis of Peripheral Pulmonary Lesions

Liang

Duan

Zhu

et al. 2022

Preprint

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Background: The diagnostic value of rapid on-site evaluation (ROSE) of cytology during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) remains controversial. The purpose of this study was to validate the value of EUBS-TBNA combined with ROSE in the diagnosis of peripheral pulmonary lesions (PPLs).Methods: Enrolled in this study were 260 patients with nodules, masses, cavities or inflammatory lesions on pulmonary CT images, and age ranged from 23 to 83 years old. They were assigned to undergo EBUS-TBNA with ROSE (n=134) or without ROSE (n=126). The diagnostic results of ROSE during EBUS-TBNA and the final pathologic reports were analyzed and compared by utilizing SPSS21.0 software to see whether the ROSE method during EBUS-TBNA would increase the risk of procedure-related complications, improve the diagnostic yield, and evaluate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: The number of punctures in ROSE group was significantly lower than that in non-ROSE group (P<0.001). There was no significant difference in hemoptysis between the two groups (P=0.402). The overall diagnostic yield of EBUS-TBNA for malignant diseases in the ROSE-group and the non-ROSE group was 29.9% and 11.1%, respectively. The sensitivity, specificity, PPV and NPV of ROSE during EBUS-TBNA were 97.4%, 96.9%, 92.5% and 98.90% respectively, showing a high agreement with the pathological results. Youden index reached 94.3%. Conclusions: ROSE examination during EBUS-TBNA could effectively improve the diagnostic yield and reduce the number of intraoperative punctures with the diagnostic results in cytology well consistent with those of traditional pathology, and therefore is worth promoting and applying in clinical practice.

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“…ROSE is preferentially performed by a cytopathologist or cytotechnologist; however, since they are not always available during the endoscopic procedure, some centres prefer to train thoracic surgeons and interventional pulmonologists to perform ROSE instead. In a recently published retrospective analysis, Lin et al reported their experience with ROSE: their results showed adequate on-site interpretation, which was carried out by trained pulmonologists, and an improvement in the diagnostic accuracy of EBUS-TBNA when combined with ROSE ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging of lung cancer

Torre¹,

Reda²,

Musso³

et al. 2021

Mediastinum

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Lung cancer is one of the leading causes of cancer-related mortality around the world. A prompt diagnosis and accurate staging are of the essence in order to establish the appropriate treatment plan. Mediastinal lymph nodes involvement is the most important parameter to define the therapeutic path, and particularly to decide whether a patient can be offered a potentially curative surgery. Endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA), together with oesophageal ultrasound (EUS), has a pivotal role in the diagnosis and staging of lung cancer. These procedures have excellent diagnostic performances, can be performed without requiring general anaesthesia, and are far less invasive than mediastinoscopy and video-assisted thoracic surgery (VATS). Moreover, EBUS-TBNA allows to biopsy intrapulmonary lymph nodes. Different studies have been investigated the diagnostic accuracy of EBUS-TBNA for the diagnosis and staging of lung cancer, with always good but heterogeneous results. In some studies, EBUS-TBNA has shown to yield adequate samples for molecular testing and immunocytochemistry too. Rapid on site cytologic evaluation (ROSE) can be used to assess the adequacy of samples during the endoscopic procedure. The aim of this review article is to describe the current evidence on the diagnostic accuracy of EBUS-TBNA for the diagnosis of lung cancer. We also reported our centre’s experience and the results of 456 EBUS-TBNA performed between April 2016 and March 2020.

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Rapid on-site cytologic evaluation by pulmonologist improved diagnostic accuracy of endobronchial ultrasound-guided transbronchial biopsy

Cited by 17 publications

References 33 publications

Cone-Beam Computed Tomography-Derived Augmented Fluoroscopy Improves the Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Biopsy for Peripheral Pulmonary Lesions

Cone-Beam Computed Tomography-Derived Augmented Fluoroscopy Improves the Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Biopsy for Peripheral Pulmonary Lesions

Value of Transbronchial Needle Aspiration Combined with Rapid on-Site Evaluation of Cytology in Diagnosis of Peripheral Pulmonary Lesions

Diagnostic accuracy of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging of lung cancer

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