Transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: a randomised trial

Zhang, Jing; Guo, Jieru; Huang, Zan-Sheng; Fu, Wan-Lei; Wu, Xianli; Wu, Na; Kuebler, Wolfgang M.; Herth, Felix J.F.; Fan, Yi

doi:10.1183/13993003.00055-2021

Cited by 96 publications

(138 citation statements)

References 32 publications

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“…One such approach is the recently reported transbronchial mediastinal cryobiopsy. Recent studies support that cryobiopsy yields larger amounts of intact tissue and has improved diagnostic yield when compared with EBUS-TBNA [ 20 , 21 , 22 ]. However, how this new technique compares with the SonoTip TopGain ® needle has not been studied.…”

Section: Discussionmentioning

confidence: 99%

Crown-Cut Endobronchial Ultrasound Guided Transbronchial Aspiration Needle: First Real-World Experiences

Oezkan

Byun

Loeffler

et al. 2021

JCM

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Advancements in personalized medicine have increased the demand for quantity and preservation of tissue architecture of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples. These demands may be addressed by the SonoTip TopGain® needle, which has a 3-point crown-cut design that contrasts with the standard single bevel design of the ViziShot 2®. The objective was to compare the SonoTip TopGain® and ViziShot 2® needles by considering biopsy sample characteristics, diagnostic accuracy, and patient safety. The primary endpoint of the study was the number of high-power fields (HPFs) in the center of the formalin-fixed paraffin-embedded cell block per sample. The lymph node with the highest probability for malignant infiltration based on size and sonographic appearance was chosen as the target lymph node for 20 patients. The same lymph node in each patient was sampled using both the ViziShot 2® and SonoTip TopGain® needles. The samples were measured, sliced, and analyzed by a pathologist. Sixteen patients were biopsied with both needles. Four patients could not be biopsied with the SonoTip TopGain® needle since it could not penetrate cartilage or be repositioned to bypass cartilage. HPFs and sample dimensions were significantly greater in the patients where sampling with the SonoTip TopGain® needle was possible (p = 0.007 and p = 0.005, respectively). Diagnostic accuracy and safety profiles were comparable. Significantly more material can be sampled using the SonoTip TopGain® needle when cartilage penetration can be avoided. This improves the yield for molecular workup in the era of personalized medicine.

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Section: Discussionmentioning

confidence: 99%

Crown-Cut Endobronchial Ultrasound Guided Transbronchial Aspiration Needle: First Real-World Experiences

Oezkan

Byun

Loeffler

et al. 2021

JCM

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“…Das Vorliegen eines malignen Lymphoms muss ausgeschlossen werden. Möglicherweise ist die EBUS-gestützte Kryo-Lymphknotenbiopsie mit kleinen Kryosonden eine Alternative zur Mediastinoskopie 16 . Die neue ATS-Leitlinie zur Diagnostik spricht eine Empfehlung für eine EBUS-TBNA der Lymphknoten aus 13 .…”

Section: Diagnostik Der Sarkoidoseunclassified

Sarkoidose

Wälscher¹,

Wessendorf²,

Darwiche³

et al. 2022

Pneumologie

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Die Sarkoidose ist eine granulomatöse Systemerkrankung und befällt meist die Lunge und thorakale Lymphknoten. Die Diagnose wird anhand des typischen klinisch-radiologischen Erscheinungsbilds und der Histologie gestellt. Die Therapie wird aufgrund einer funktionellen Einschränkung, organbezogener oder systemischer Symptomatik und lebensbedrohlicher Organmanifestationen indiziert. Bisher gibt es keine zugelassene medikamentöse Therapie für die Sarkoidose. Die Gabe von Immunsuppressiva wie Glukokortikosteroide und ggf. als Add-on oder sequenziell Methotrexat, Azathioprin oder Mycophenolat-Mofetil wird von der aktuell publizierten internationalen Leitlinie empfohlen.

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“…The diagnostic yield was similar in malignant lymphadenopathy. Two cases of pneumothorax and one case of pneumomediastinum were reported [ 33 ].…”

Section: Procedure-related Technical Factors and Their Effects On Diagnostic Yieldmentioning

confidence: 99%

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): Technical Updates and Pathological Yield

et al. 2021

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Since the endobronchial ultrasound bronchoscope was introduced to clinical practice, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the procedure of choice to sample hilar and mediastinal adenopathy. Multiple studies have been conducted in the last two decades to look at the different technical aspects of the procedure and their effects on the final cytopathological yield. In addition, newer modes of ultrasound scanning and newer tools with the potential to optimize the selection and sampling of the target lymph node have been introduced. These have the potential to reduce the number of passes, reduce the procedure time, and increase the diagnostic yield, especially in rare tumors and benign diseases. Herein, we review the latest updates related to the technical aspects of EBUS-TBNA and their effects on the final cytopathological yield in malignant and benign diseases.

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Transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: a randomised trial

Cited by 96 publications

References 32 publications

Crown-Cut Endobronchial Ultrasound Guided Transbronchial Aspiration Needle: First Real-World Experiences

Crown-Cut Endobronchial Ultrasound Guided Transbronchial Aspiration Needle: First Real-World Experiences

Sarkoidose

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): Technical Updates and Pathological Yield

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