Transbronchial Needle Aspiration in Diagnosing and Staging Lung Cancer

Chin, Robert; McCain, Trent W.; Lucia, Michael A.; Cappellari, James O.; Adair, Norman E.; Lovato, James; Dunagan, Donnie P.; Brooks, Michael; Clark, Hollins P.; Haponik, Edward F.

doi:10.1164/rccm.2106153

Cited by 125 publications

(85 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results demonstrated that EBUS-TBNA performed better compared with conventional TBNA and were consistent with those of well-designed previous studies (13,15). Shannon et al (16) reported that the ROSE method they used improved the diagnostic accuracy, which was consistent with the results of Chin et al (23); however, it requires costly and sophisticated equipment. In the studies of Herth et al (14) and Arslan et al (12), the patients were stratified according to the anatomic location of the pathological lymph nodes.…”

Section: Discussionsupporting

confidence: 92%

Endobronchial ultrasound guided-transbronchial needle aspiration vs. conventional transbronchial needle aspiration in the diagnosis of mediastinal masses: A meta-analysis

Zhu

Zhang

et al. 2013

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. Whether an endobronchial ultrasound (EBUS)is required for transbronchial needle aspiration (TBNA) in the diagnosis of mediastinal masses is currently a disputed subject. Previous studies have demonstrated that EBUS-TBNA performs better compared to conventional TBNA as it is capable of sampling in real-time compared with conventional TBNA. However, some clinicians consider conventional TBNA to be sufficient for diagnosis. In this meta-analysis, we evaluated these two methods according to diagnostic yield. A search was conducted through PubMed, Embase and the proceedings of major conferences, for studies comparing TBNA with EBUS-TBNA in the diagnosis of mediastinal masses. The identified studies were evaluated for publication bias and heterogeneity. The primary outcome was diagnostic yield. Pooled odds ratio (OR) estimated with 95% confidence intervals (CIs) was calculated using the fixed-effects model. Five studies, including a total of 407 patients, were included in the meta-analysis. The EBUS-TBNA arm was associated with a significantly higher OR compared to that of the TBNA arm in terms of diagnostic yield (OR=2.72, 95% CI: 1.72-4.30, P<0.001). There was no evidence of heterogeneity (I 2 =0%, P=0.540) or publication bias (Egger's test, P= 0.568; Begg-Mazumdar test, P=0.806). In conclusion, EBUS-TBNA and conventional TBNA are safe and provide good diagnostic yield in the diagnosis of hilar and mediastinal masses and lymphadenopathies; however, EBUS-TBNA performs better compared to conventional TBNA, with a shorter aspiration time and higher sensitivity. IntroductionClinically, mediastinal masses are currently a common occurrence. The incidence of certain diseases, such as lung cancer and sarcoidosis, is on the increase. Accurate and early diagnosis of such diseases is crucial for the appropriate treatment and prognosis (1,2). A major concern for clinicians worldwide is the establishment of a diagnostic method that is fast, accurate and minimally invasive.Imaging is crucial in the diagnosis of mediastinal masses. An imaging scan may provide critical information with regard to the location, size and periphery of the lesions and it is fast and non-invasive. Positron emission tomography-computed tomography (PET-CT) may also indicate whether the mass is benign or malignant. However, more precise information is required for staging and typing.Although mediastinoscopy or surgery is considered to be the gold standard for diagnosis (3), some patients are unable to tolerate the procedural injury and intravenous anesthesia. Therefore, efforts are focused on establishing a method that is easy to use, minimally invasive and efficient in providing the critical information required.Transbronchial biopsy is such a method, particularly transbronchial needle aspiration (TBNA), which aspirates masses and pathological lymph nodes through an air tube, with minimal invasion (4). However, conventional TBNA requires the assistance of X-ray, CT or PET-CT; therefore, there remains the need for equipment that may guide real-tim...

show abstract

Section: Discussionsupporting

confidence: 92%

Endobronchial ultrasound guided-transbronchial needle aspiration vs. conventional transbronchial needle aspiration in the diagnosis of mediastinal masses: A meta-analysis

Zhu

Zhang

et al. 2013

Molecular and Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…This factor could also explain the wide range of diagnostic yields reported in the literature [5,8]. Until recently, the procedure was performed without guidance and, in order to compensate for this drawback and to increase diagnostic yield, repeated aspirates, up to a total number of seven, and/or rapid on-site sample evaluation have been proposed [16]. The introduction of EBUS has recently led to major progress, and HERTH et al [9] have shown that TBNA performed after EBUS localisation is better than conventional TBNA in patients with enlarged lymph nodes on CT scan.…”

Section: Limitations Of the Studymentioning

confidence: 99%

Endobronchial ultrasound and positron emission tomography positive mediastinal lymph nodes

Plat

Pierard²,

Haller³

et al. 2006

European Respiratory Journal

View full text Add to dashboard Cite

Positron emission tomography with 18F-fluoro-2-deoxy-D-glucose (FDG-PET) is more accurate than computed tomography for staging of mediastinal (hilar) lymph nodes. In the case of positive findings, tissue sampling of lymph nodes is required. The diagnostic/staging yield of transbronchial needle aspiration (TBNA) following endobronchial ultrasound (EBUS) localisation was assessed in this particular clinical setting. The number of avoided surgical procedures was evaluated.All consecutive patients referred for staging and/or diagnosis of mediastinal FDG-PET positive lesions were included. Data were prospectively collected. TBNA sampling of lymph nodes was performed after EBUS localisation. If no diagnosis was reached, further surgical sampling or adequate follow-up was performed.From January 2003 to June 2004, 33 patients were included. The average number of TBNA samples per patient was 4.2¡1.5. Cytological or histological diagnoses were obtained in 27 (82%) of the patients, of which 78% were obtained after previous EBUS localisation. In 25 (76%) of the 33 patients, surgical staging procedures were suppressed.In conclusion, transbronchial needle aspiration after endobronchial ultrasound localisation should be considered as a primary method of evaluation of lymph nodes positive by positron emission tomography with 18F-fluoro-2-deoxy-D-glucose, and may replace the majority of surgical mediastinal staging/diagnostic procedures.

show abstract

“…[20,21] In our study, the number of needle passes required for successful lymph node sampling was 2.8±2 in total, 2.5±1.6 in malignant disease, and 2.6±2.2 in benign disease; however, this number was 4.4±2 in undiagnosed group (Table 2). Our threshold of needle passes for diagnosis was 2.5 and its sensitivity, specificity and AUC were 60%, 87%, and 79%, respectively.…”

Section: Discussionmentioning

confidence: 52%

Should transbronchial needle aspiration and rapid on-site cytologic evaluation be performed before mediastinoscopy? “Analysis of 239 cases”

Cangır¹

2016

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

Transbronchial Needle Aspiration in Diagnosing and Staging Lung Cancer

Cited by 125 publications

References 24 publications

Endobronchial ultrasound guided-transbronchial needle aspiration vs. conventional transbronchial needle aspiration in the diagnosis of mediastinal masses: A meta-analysis

Endobronchial ultrasound guided-transbronchial needle aspiration vs. conventional transbronchial needle aspiration in the diagnosis of mediastinal masses: A meta-analysis

Endobronchial ultrasound and positron emission tomography positive mediastinal lymph nodes

Should transbronchial needle aspiration and rapid on-site cytologic evaluation be performed before mediastinoscopy? “Analysis of 239 cases”

Contact Info

Product

Resources

About