scholarly journals COMPARISON OF DIAGNOSTIC YIELD OF ELECTROMAGNETIC NAVIGATION BRONCHOSCOPY-GUIDED TRANSBRONCHIAL FORCEPS BIOPSY TO TRANSBRONCHIAL NEEDLE ASPIRATION IN THE DIAGNOSIS OF PERIPHERAL PULMONARY LESIONS

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A1949
Author(s):  
Olaedo Abana ◽  
Uzair Ghori ◽  
Robert Holladay ◽  
Derek Rainwater ◽  
Rusella Mirza
Keyword(s):  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Transbronchial Needle Aspiration ◽  
Electromagnetic Navigation ◽  
Forceps Biopsy ◽  
Pulmonary Lesions ◽  
Peripheral Pulmonary Lesions

scholarly journals Radial-probe EBUS for the diagnosis of peripheral pulmonary lesions

2016 ◽  
Vol 42 (4) ◽  
pp. 248-253 ◽  
Author(s):  
Marcia Jacomelli ◽  
Sergio Eduardo Demarzo ◽  
Paulo Francisco Guerreiro Cardoso ◽  
Addy Lidvina Mejia Palomino ◽  
Viviane Rossi Figueiredo
Keyword(s):  
Diagnostic Yield ◽  
Pulmonary Nodules ◽  
High Sensitivity ◽  
Needle Aspiration ◽  
Tertiary Hospital ◽  
Target Lesion ◽  
Transbronchial Needle Aspiration ◽  
Pulmonary Lesions ◽  
Mean Diameter ◽  
Peripheral Pulmonary Lesions

ABSTRACT Objective: Conventional bronchoscopy has a low diagnostic yield for peripheral pulmonary lesions. Radial-probe EBUS employs a rotating ultrasound transducer at the end of a probe that is passed through the working channel of the bronchoscope. Radial-probe EBUS facilitates the localization of peripheral pulmonary nodules, thus increasing the diagnostic yield. The objective of this study was to present our initial experience using radial-probe EBUS in the diagnosis of peripheral pulmonary lesions at a tertiary hospital. Methods: We conducted a retrospective analysis of 54 patients who underwent radial-probe EBUS-guided bronchoscopy for the investigation of pulmonary nodules or masses between February of 2012 and September of 2013. Radial-probe EBUS was performed with a flexible 20-MHz probe, which was passed through the working channel of the bronchoscope and advanced through the bronchus to the target lesion. For localization of the lesion and for collection procedures (bronchial brushing, transbronchial needle aspiration, and transbronchial biopsy), we used fluoroscopy. Results: Radial-probe EBUS identified 39 nodules (mean diameter, 1.9 ± 0.7 cm) and 19 masses (mean diameter, 4.1 ± 0.9 cm). The overall sensitivity of the method was 66.7% (79.5% and 25.0%, respectively, for lesions that were visible and not visible by radial-probe EBUS). Among the lesions that were visible by radial-probe EBUS, the sensitivity was 91.7% for masses and 74.1% for nodules. The complications were pneumothorax (in 3.7%) and bronchial bleeding, which was controlled bronchoscopically (in 9.3%). Conclusions: Radial-probe EBUS shows a good safety profile, a low complication rate, and high sensitivity for the diagnosis of peripheral pulmonary lesions.

scholarly journals Transbronchial needle aspiration in peripheral pulmonary lesions: a systematic review and meta-analysis

2016 ◽  
Vol 48 (1) ◽  
pp. 196-204 ◽  
Author(s):  
Michele Mondoni ◽  
Giovanni Sotgiu ◽  
Martina Bonifazi ◽  
Simone Dore ◽  
Elena Maria Parazzini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Sampling Technique ◽  
Needle Aspiration ◽  
Lesion Size ◽  
Transbronchial Needle Aspiration ◽  
Pulmonary Lesions ◽  
Site Evaluation ◽  
Peripheral Pulmonary Lesions

Fluoroscopy-guided transbronchial needle aspiration (TBNA) has long been used in the diagnosis of peripheral pulmonary lesions (PPLs), although its diagnostic performance varies considerably.We conducted a systematic review and meta-analysis evaluating the accuracy of TBNA in the diagnosis of PPLs, comparing its diagnostic yield with transbronchial biopsy (TBB) and assessing the main predictors of a successful aspirate.In 18 studies, the overall TBNA yield was 0.53 (95% CI 0.44–0.61). TBNA showed a higher accuracy when directly compared to TBB (0.60 (95% CI 0.49–0.71) versus 0.45 (95% CI 0.37–0.54)). The subgroup analyses documented a higher TBNA yield when the computed tomography (CT) bronchus sign was present (0.70 (95% CI 0.63–0.77) versus 0.51 (95% CI 0.38–0.64)), when rapid on-site evaluation (ROSE) was performed (0.62 (95% CI 0.43–0.79) versus 0.51 (95% CI 0.42–0.60)), in the case of malignant lesions (0.55 (95% CI 0.44–0.66) versus 0.17 (95% CI 0.11–0.24)) and for lesions >3 cm (0.81 (95% CI 0.73–0.87) versus 0.55 (95% CI 0.47–0.63)).Conventional TBNA is a useful sampling technique for the diagnosis of PPL, with a higher diagnostic yield than TBB. The presence of CT bronchus sign, an underlying malignant process, lesion size >3 cm and ROSE employment are predictors of a higher yield.

scholarly journals 4D Electromagnetic Navigation Bronchoscopy for the Sampling of Pulmonary Lesions: First European Real-Life Experience

Lung ◽  
2021 ◽  
Vol 199 (5) ◽  
pp. 493-500
Author(s):  
Filippo Patrucco ◽  
Matteo Daverio ◽  
Chiara Airoldi ◽  
Zeno Falaschi ◽  
Vittorio Longo ◽  
...  
Keyword(s):  
Respiratory Motion ◽  
Life Experience ◽  
Diagnostic Yield ◽  
Real Life ◽  
Needle Aspiration ◽  
Navigation Systems ◽  
Transbronchial Needle Aspiration ◽  
Electromagnetic Navigation ◽  
Pulmonary Lesions ◽  
Multimodality Approach

Abstract Purpose The use of Electromagnetic navigation bronchoscopy (ENB) for the diagnosis of pulmonary peripheral lesions is still debated due to its variable diagnostic yield; a new 4D ENB system, acquiring inspiratory and expiratory computed tomography (CT) scans, overcomes respiratory motion and uses tracked sampling instruments, reaching higher diagnostic yields. We aimed at evaluating diagnostic yield and accuracy of a 4D ENB system in sampling pulmonary lesions and at describing their influencing factors. Methods We conducted a three-year retrospective observational study including all patients with pulmonary lesions who underwent 4D ENB with diagnostic purposes; all the factors potentially influencing diagnosis were recorded. Results 103 ENB procedures were included; diagnostic yield and accuracy were, respectively, 55.3% and 66.3%. We reported a navigation success rate of 80.6% and a diagnosis with ENB was achieved in 68.3% of cases; sensitivity for malignancy was 61.8%. The majority of lesions had a bronchus sign on CT, but only the size of lesions influenced ENB diagnosis (p < 0.05). Transbronchial needle aspiration biopsy was the most used tool (93.2% of times) with the higher diagnostic rate (70.2%). We reported only one case of pneumothorax. Conclusion The diagnostic performance of a 4D ENB system is lower than other previous navigation systems used in research settings. Several factors still influence the reachability of the lesion and therefore diagnostic yield. Patient selection, as well as the multimodality approach of the lesion, is strongly recommended to obtain higher diagnostic yield and accuracy, with a low rate of complications.

Diagnostic yield of conventional transbronchial needle aspiration in suspected bronchogenic carcinoma without intraluminal growth on bronchoscopy

2017 ◽  
Vol 5 (4) ◽  
pp. 1270 ◽  
Author(s):  
Davis Kizhakkepeedika Rennis ◽  
Easwaramangalath Venugopal Krishnakumar ◽  
Navmi Sankarapotti
Keyword(s):  
Bronchogenic Carcinoma ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Transbronchial Needle Aspiration ◽  
Ct Guided ◽  
Forceps Biopsy ◽  
Bronchial Washing ◽  
Intraluminal Mass

Background: Bronchogenic carcinoma with spread along the mucosal plane presents as an exophytic mass. Most of the submucosal and peribronchial patterns of this malignancy are harder to detect by standard diagnostic procedures such as bronchial washing, brushing and forceps biopsy. We sought to investigate the utility of transbronchial needle aspiration (TBNA) in the diagnosis of bronchogenic carcinoma without intraluminal mass, through prospective analysis of routine diagnostic bronchoscopies performed in a 24-month period, at a tertiary care hospital.Methods: Patients with suspected bronchogenic carcinoma (clinical and radiological) underwent standard computed tomography (CT) of thorax. Further the patients were subjected to conventional TBNA, singly, and in combination with bronchial washings and brushings. The results were analyzed statistically for the diagnostic yield of TBNA.Results: Among the 42 patients assessed, 29 had malignancy confirmed by forceps biopsy or CT guided Fine Needle aspiration cytology or biopsy and bronchoscopy. Among them, 17 cases were detected by a combination of the results of bronchial washing, brushing and TBNA. The individual sensitivities amounted to 3.4% (n=1), 51.72% (n=15) and 27.6% (n=8), respectively. There were no false positive results. Concerning different bronchoscopic sampling techniques, 9 cases were diagnosed solely by bronchial brushings and 2 cases by TBNA alone. No periprocedural complications were encountered.Conclusions: Value of bronchial brushing in the diagnosis of bronchogenic carcinoma without bronchoscopically visible intraluminal mass is above that of conventional TBNA. Addition of bronchial washings, to bronchial brushings and TBNA has an insignificant impact on the diagnosis.

Performance characteristics and predictors of yield from transbronchial needle aspiration in the diagnosis of peripheral pulmonary lesions

Respirology ◽  
2011 ◽  
Vol 16 (7) ◽  
pp. 1144-1149 ◽  
Author(s):  
ROCCO TRISOLINI ◽  
ALESSANDRA CANCELLIERI ◽  
CARMINE TINELLI ◽  
DANIELA PAIOLI ◽  
LUIGIA SCUDELLER ◽  
...  
Keyword(s):  
Needle Aspiration ◽  
Performance Characteristics ◽  
Transbronchial Needle Aspiration ◽  
Pulmonary Lesions ◽  
Peripheral Pulmonary Lesions

Rapid on-site evaluation of touch imprints of biopsies improves the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy: a retrospective study

2021 ◽  
Author(s):  
Hansheng Wang ◽  
Tao Ren ◽  
Xiao Wang ◽  
Na Wei ◽  
Guoshi Luo ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Transbronchial Biopsy ◽  
Transbronchial Needle Aspiration ◽  
Forceps Biopsy ◽  
Significant Difference ◽  
Evaluation Group ◽  
Site Evaluation ◽  
High Level

Abstract Objective Rapid on-site evaluation has long been used for transbronchial needle aspiration or fine-needle aspiration to evaluate the adequacy of biopsy materials for the diagnosis of peripheral lung lesions. However, research on rapid on-site evaluation combined with transbronchial forceps biopsy in the diagnosis of lung carcinoma is rarely reported. Therefore, we aimed to investigate the value of rapid on-site evaluation during transbronchial forceps biopsy for endoscopically visible (tumor, infiltrative and necrotic) or nonvisible (compressive, nonspecific and normal) malignancy. Methods A retrospective analysis was performed between January 2015 and January 2019 in Taihe Hospital with 1216 lung cancer patients who underwent bronchoscopy procedures, and these patients were allocated into the rapid on-site evaluation group and non-rapid on-site evaluation group, depending on the timing of the procedure. According to endoscopic features, bronchoscopic appearance was described as endoscopically visible malignancy (tumor, infiltrative and necrotic) and endoscopically nonvisible malignancy (compressive, nonspecific and normal). The diagnostic yield was compared, and the concordance between the rapid on-site evaluation results and the final histology was analyzed. Results There was a statistically significant difference in the diagnostic yield between the rapid on-site evaluation and non-rapid on-site evaluation groups for endoscopically nonvisible malignancy (74.3% vs. 51.7%, P &lt; 0.05). However, we found no significant improvement in terms of diagnostic yield for endoscopically visible malignancy (95.2% vs. 91.2%, P &gt; 0.05). The rapid on-site evaluation results showed high-level concordance with histology in the diagnosis of squamous cell carcinoma, adenocarcinoma and small cell carcinoma, with kappa values of 0.749 (P &lt; 0.05), 0.728 (P &lt; 0.05) and 0.940 (P &lt; 0.05), respectively. Conclusions The findings demonstrated that the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy (compressive, nonspecific and normal) was significantly improved when rapid on-site evaluation was implemented. In addition, the rapid on-site evaluation results had high-level concordance with the final histological diagnosis.

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