Transesophageal pulmonary nodule biopsy using endoscopic ultrasonography

Nasir, Basil S.; Edwards, Marcel; Tiffault, Vicky; Kazakov, Jordan; Khereba, Mohammed; Ferraro, Pasquale; Liberman, Moïshe

doi:10.1016/j.jtcvs.2014.06.007

Cited by 12 publications

(17 citation statements)

References 13 publications

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“…Although there are previous reports of EUS-FNA of a lung tumor adjacent to the esophagus ( 1 , 2 ), our case illustrated the possibility of transesophageal EUS-FNA of a lung tumor that was appeared to be non-abutting on CT. Despite CT findings, the lung tumor was successfully visualized on EUS because the esophagus had some mobility in the mediastinum.…”

Section: Discussioncontrasting

confidence: 55%

Transesophageal Endoscopic Ultrasound-guided Fine Needle Aspiration for the Diagnosis of a Lung Nodule that Was Non-abutting on CT

et al. 2017

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An 80-year-old man presented with a right side lung tumor. The tumor was not abutting the bronchus or chest wall; thus, endobronchial ultrasound (EBUS) and CT-guided biopsy were considered to be technically difficult. We therefore attempted endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). Although the nodule was not abutting the esophagus on CT, an irregularly shaped hypoechoic lesion was visualized on EUS. EUS-FNA was successfully performed. The tumor was diagnosed as squamous cell carcinoma. This case illustrates that transesophageal EUS-FNA may be feasible when diagnostic procedures such as EBUS- or CT-guided biopsy are considered to be technically difficult.

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Section: Discussioncontrasting

confidence: 55%

Transesophageal Endoscopic Ultrasound-guided Fine Needle Aspiration for the Diagnosis of a Lung Nodule that Was Non-abutting on CT

et al. 2017

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“…The electronic searches yielded 3,320 search results, from which 10 studies were included [19][20][21][22][23][24][25][26][27][28] . Two of these included studies were conference abstracts [21,26] .…”

Section: Study Selectionmentioning

confidence: 99%

“…VazquezSequeiros [27], 2013 "lung masses […] with the closest margin believed to be in sufficient proximity to the esophageal wall"; "lung masses were located in the vicinity of the cervical/upper esophagus (n = 19; each <1 cm from esophagus) or mid esophagus (n = 43; each <2 cm from the esophagus)" Nasir [28], 2014 "lung mass suspicious for either a primary or secondary neoplasm of the lung"; "mean distance between lesion and esophagus: 25 mm (range 0 -46)" Steinfort [29], 2016 "pulmonary parenchymal lesions […] adjacent to the esophagus on Computed Tomography of the chest" from the analysis in whom intrapulmonary tumors could not be visualized by EUS. Four studies used a suboptimal reference standard in at least some of the patients, and 2 studies excluded patients due to missing reference standard results.…”

Section: Study Qualitymentioning

confidence: 99%

Esophageal Endosonography for the Diagnosis of Intrapulmonary Tumors: A Systematic Review and Meta-Analysis

Korevaar

Colella²,

Spijker³

et al. 2016

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Background: Biopsy-based diagnosis in patients with paraesophageal intrapulmonary tumors suspected of lung cancer is crucial for adequate treatment planning. Objective: To evaluate the performance of transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the diagnosis of intrapulmonary tumors located near or adjacent to the esophagus. Methods: We performed a systematic review (PROSPERO, CRD42016033737) and searched MEDLINE, Embase, BIOSIS Previews, and Web of Science on September 22, 2016, without date or language restrictions. We included studies that evaluated the yield and/or sensitivity of EUS-FNA for diagnosing intrapulmonary tumors. Yield was defined as the number of patients in whom EUS-FNA made a biopsy-proven diagnosis (malignant or nonmalignant) relative to the total number of patients on whom EUS-FNA was performed. Sensitivity was defined as the number of patients in whom EUS-FNA made a biopsy-proven diagnosis of malignancy relative to the total number of patients in whom the tumor was found to be malignant. We performed a random-effects meta-analysis. Results: Of 3,320 search results, 11 studies were included. Ten had a high risk of bias. The total number of patients was 313; the proportion of patients with malignancy ranged from 87 to 100% across these studies. The average yield was 0.90 (95% CI 0.82-0.95) and the average sensitivity was 0.92 (0.83-0.96). In the subgroup of prospective studies (n = 3), the average yield was 0.80 (0.56-0.93) and the average sensitivity was 0.83 (0.58-0.95). EUS-FNA-induced complications were reported for 5/256 patients (2.0%) for whom this information was available. Conclusions: Although the number of high-quality studies is limited, these findings suggest that EUS-FNA is safe and has a high yield for diagnosing intrapulmonary tumors.

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“…Unfortunately, it is unknown what the term "immediately adjacent" covers. Studies on EUS-FNA from intrapulmonary tumors [2][3][4][5][6][7][8][9][10][11] rarely report the distance between esophagus and the lung tumor. When reported, the distances vary greatly (from below 10 up to 46 mm) [3,4,10,11].…”

Section: Introductionmentioning

confidence: 99%

Characterization of Lung Tumors that the Pulmonologist can Biopsy from the Esophagus with Endosonography (EUS-B-FNA)

et al. 2021

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Background: According to guidelines, it is possible to biopsy lung tumors “immediately adjacent to the esophagus” with EUS-B-FNA. However, it is unknown what “immediately adjacent” exactly means. Objective: to investigate the possibility of achieving EUS-B-FNA biopsies from a lung tumor depending on the distance from the esophagus and to establish the maximal allowable distance between the tumor and the esophagus. Methods: In a prospective observational study, we included patients with a lung tumor located maximum 6 cm from the esophagus and indication of EUS-B-FNA from the tumor. The tumors were of different sizes. In a plot presenting the tumor size-distance relationship in cases with (biopsy) versus without (non-biopsy) successful EUS-B-FNA, a separation line representing the threshold between the groups were identified and a biopsy-index equation established. The maximal tumor-size corrected distance (TSCD) was calculated using the residuals to the separation line. Results: In total, 70 patients were included. EUS-B-FNA from the lung tumor was possible in 46 patients. All tumors with a distance from the esophagus below 19 mm could be biopsied. The maximal allowable esophagus-tumor distance depended on tumor size. From the separation line, a biopsy-index equation was established with the sensitivity of 93.5%, a specificity of 100%, and total accuracy of 95.7%. The TSCD was 31 mm (sensitivity: 95.7%, specificity 75.0%, and accuracy: 88.6%). Conclusion: We established a biopsy-index equation to predict the achievability of a lung tumor using EUS-B-FNA depending on distance to esophagus and tumor size. A general maximal TSCD was 31 mm.

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Transesophageal pulmonary nodule biopsy using endoscopic ultrasonography

Abstract: EUS-FNA of parenchymal pulmonary nodules is safe and accurate and allows for biopsy of perimediastinal lung lesions not attainable using traditional techniques.

Cited by 12 publications

References 13 publications

Transesophageal Endoscopic Ultrasound-guided Fine Needle Aspiration for the Diagnosis of a Lung Nodule that Was Non-abutting on CT

Transesophageal Endoscopic Ultrasound-guided Fine Needle Aspiration for the Diagnosis of a Lung Nodule that Was Non-abutting on CT

Esophageal Endosonography for the Diagnosis of Intrapulmonary Tumors: A Systematic Review and Meta-Analysis

Characterization of Lung Tumors that the Pulmonologist can Biopsy from the Esophagus with Endosonography (EUS-B-FNA)

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