Use of an Additional 19-G EBUS-TBNA Needle Increases the Diagnostic Yield of EBUS-TBNA

Abstract

In select cases where additional tissue may be needed, sampling with a 19-G EBUS needle following standard aspiration with a 22-G needle results in an increase in diagnostic yield.

Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies: Guideline From the College of American Pathologists in Collaboration With the American College of Chest Physicians, Association for Molecular Pathology, American Society of Cytopathology, American Thoracic Society, Pulmonary Pathology Society, Papanicolaou Society of Cytopathology, Society of Interventional Radiology, and Society of Thoracic Radiology

“…One systematic review from a clinical practice guideline produced on behalf of the World Association of Bronchology and Interventional Pulmonology Task Force, 27 2 randomized controlled trials (RCTs), 28,29 2 prospective cohort studies, 30,31 and 4 retrospective cohort studies [32][33][34][35] comprise the evidence base for statement 2. The systematic review 27 carried a low risk of bias, with the only limitation being unclear reporting of whether the study used dual study selection and data extraction.…”

“…The systematic review 27 carried a low risk of bias, with the only limitation being unclear reporting of whether the study used dual study selection and data extraction. Both RCTs, 28,29 1 prospective cohort study, 31 and all the retrospective cohort studies [32][33][34][35] were published after the search date of the systematic review. The aggregate risk of bias across these studies was very serious.…”

“…The aggregate risk of bias across these studies was very serious. 28,29,[31][32][33][34][35] An additional prospective cohort study, 30 which did not evaluate needle gauge in relation to sufficiency for ancillary testing but did report on the outcome, was included as indirect evidence for this statement and was limited by a serious risk of bias. None of the studies were found to have methodologic flaws that would raise concerns about the findings.…”

Linear Endobronchial Ultrasound: What's New?

“…23 Similarly, adding EBUS-TBNA with a 19G needle to that with a 22G one for mixed conditions (including benign and malignant diseases) significantly increased the yield from 92 to 98%. 10 In summary, these data suggest the "histology" tools (19G needle and miniforceps) may be complementary to or even replace EBUS-TBNA with "cytology" tools in selected cases. Clinical trials are ongoing (NCT03573362 and NCT02592837).…”

Biopsy needles for mediastinal lymph node sampling by endosonography: current knowledge and future perspectives

“…In comparison to samples collected with a 22G needle (25) In a cohort of 48 patients that underwent EBUS-TBNA with a 22G needle and subsequently with a 19G needle, the latter allowed a significant increase in the diagnostic yield from 92% to 99%. Four patients (8%) received a diagnosis only with a 19G needle and in 3 cases (6%) the diagnosis was provided only by the 22G needle (26). On the other hand, the 19G needle did not show a superiority over a 22G needle, however, the 19G needle samples had the advantage to be less bloody than 22G needle samples but, conversely, were significantly less frequently adequate (27).…”