Transbronchial needle aspiration "by the books"

Küpeli̇, Eli̇f; Memış, Leyla; Özdemirel, Tuğçe Şahin; Ulubay, Gaye; Akçay, Şule; Eyüboğlu, Füsun Öner

doi:10.4103/1817-1737.78427

Cited by 17 publications

(19 citation statements)

References 32 publications

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“…Out of seven studies that assessed this outcome in an unselected population, six reported higher sensitivity for lymph nodes ≥2 cm in the short axis with a linear relationship with increasing size, when evaluated [5,9,10,12,13,14]. Similar results were obtained in four out of seven studies, involving patients with suspected/known lung cancer [20,21,22,25].…”

Section: Resultssupporting

confidence: 71%

“…Another four studies [12,13,14,15] did not find any significant statistical difference. Eleven studies evaluated this factor in patients with suspected/known diagnosis of lung cancer.…”

Section: Resultsmentioning

confidence: 99%

“…Out of eight studies that evaluated the type of disease as the predictor, seven reported higher sensitivity for malignant (excluding lymphoma) than benign lesions, such as sarcoidosis and tuberculosis [10,13,14,37,38,39,40], while one study did not find any statistically significant difference based on the underlying disease [12]. …”

Section: Resultsmentioning

confidence: 99%

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Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

et al. 2013

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Background: Transbronchial needle aspiration (TBNA) is a safe and useful sampling technique for the diagnosis of mediastinal adenopathies/masses, but its accuracy seems to be influenced by selected clinical and procedural aspects. Objectives: We performed a systematic review to identify the main predictors of a successful transbronchial aspirate according to different clinical settings. Methods: We searched Medline and Embase for all studies evaluating predictors of TBNA diagnostic yield, published up to February 2012. Two authors reviewed all titles/abstracts and retrieved the full text of articles that are potentially relevant to identify studies according to predefined selection criteria. The methodological quality of studies was assessed through the revised Quality Assessment of Diagnostic Accuracy Studies tool. Evidence synthesis was graded according to overall number of studies, patients involved and methodological features. Results: Fifty-three studies, involving more than 8,000 patients and evaluating 23 potential predictive factors, were included. Major predictors in an unselected population, as well as in patients with suspected/known lung cancer, included lymph node size (short axis length ≥2 cm), presence of abnormal endoscopic findings, subcarinal and right paratracheal location, and the use of histological needle by an experienced bronchoscopist. Stage I and sampling of more than one lymph node stations were the only predictors of a successful TBNA result in patients with suspected sarcoidosis. Conclusions: The diagnostic yield of TBNA depends on selected clinical and procedural features. Knowledge of factors that predict a positive TBNA result may help optimize the diagnostic success of the procedure in different clinical settings.

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Section: Resultssupporting

confidence: 71%

“…Another four studies [12,13,14,15] did not find any significant statistical difference. Eleven studies evaluated this factor in patients with suspected/known diagnosis of lung cancer.…”

Section: Resultsmentioning

confidence: 99%

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Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

et al. 2013

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“…Conventional transbronchial needle aspiration is an established method for diagnosing mediastinal pathologies. We have been performing this procedure at our institution since 2009, with a success rate similar to previous published reports . In recent years, there has been increasing interest in endobronchial ultrasound‐guided transbronchial needle aspiration as evident by the increasing number of publications, international seminars and hands‐on courses .…”

supporting

confidence: 66%

EBUS‐TBNA: Popular but not universal

Ulaşlı

Küpeli̇

2013

Respirology

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In recent years, the number of publications concerning interventional bronchoscopy has increased dramatically. The present paper focused on publications related to endobronchial ultrasound technique. Its aim was to provide an overview of the nature of publications about endobronchial ultrasound technique, especially with regard to the countries of origin of publications and the categories of journals in which these papers are published. Overall, the review demonstrates a limited use of endobronchial ultrasound technique in many countries.

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“…However, these methods are not widely practiced, often because of a perceived low diagnostic yield or risk of pneumothorax or hemoptysis. [18–21] More invasive tools such as surgical mediastinoscopy or thoracoscopy may pose significant risk, as well as cost, to the patient, requiring general anesthesia and operating room use. [22]…”

Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of non-lymph node thoracic lesions

Yang¹,

Zhao²,

Garfield³

et al. 2013

Ann Thorac Med

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AIMS:Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has shown excellent diagnostic capabilities for mediastinal and hilar lymphadenopathy. However, its value in thoracic non-lymph node lesions is less clear. This study was designed to assess the value of EBUS-TBNA in distinguishing malignant from benign thoracic non-lymph node lesions.METHODS:From October 2009 to August 2011, 552 patients underwent EBUS-TBNA under local anesthesia and with conscious sedation. We retrospectively reviewed 81 of these patients who had tracheobronchial wall-adjacent intrapulmonary or isolated mediastinal non-lymph node lesions. On-site cytological evaluation was not used. Immunohistochemistry (IHC) was performed to distinguish the origin or type of malignancy when necessary.RESULTS:EBUS-TBNA was performed in 68 tracheobronchial wall-adjacent intrapulmonary and 13 isolated mediastinal non-lymph node lesions. Of the 81 patients, 77 (95.1%, 60 malignancies and 17 benignancies) were diagnosed through EBUS-TBNA, including 57 primary lung cancers, 2 mediastinal tumors, 1 pulmonary metastatic adenocarcinoma, 7 inflammation, 5 tuberculosis, 3 mediastinal cysts, 1 esophageal schwannoma, and 1 focal fibrosis. There were four false-negative cases (4.9%). Of the 60 malignancies, there were 9 (15.0%) which originally had no definite histologic origin or type. Thus, IHC was performed, with 7 (77.8%) being subsequently confirmed. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA in distinguishing malignant from benign lesions were 93.4% (60/64), 100% (17/17), 100% (60/60), 81.0% (17/21), and 95.1% (77/81), respectively.CONCLUSION:EBUS-TBNA is a safe procedure with a high sensitivity for distinguishing malignant from benign thoracic non-lymph node lesions within the reach of EBUS-TBNA, with IHC usually providing a more definitive diagnosis.

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Transbronchial needle aspiration "by the books"

Cited by 17 publications

References 32 publications

Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

Transbronchial Needle Aspiration: A Systematic Review on Predictors of a Successful Aspirate

EBUS‐TBNA: Popular but not universal

Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of non-lymph node thoracic lesions

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