scholarly journals Evaluation of histological specimens obtained by two types of EBUS-TBNA needles: a comparative study

2020 ◽  
Vol 50 (11) ◽  
pp. 1298-1305
Author(s):  
Keigo Uchimura ◽  
Kei Yamasaki ◽  
Shinji Sasada ◽  
Sachika Hara ◽  
Takashi Tachiwada ◽  
...  
Keyword(s):  
Stainless Steel ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Complication Rates ◽  
Procedure Time ◽  
Cobalt Chromium ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Stainless Steel Needle

Abstract Background Endobronchial ultrasound-guided transbronchial needle aspiration is a standard method for obtaining specimens of mediastinal and hilar lesions. Several types of needles of various sizes and materials are available. This study aimed to compare the quality of specimens collected using two needles, cobalt chromium and stainless steel for endobronchial ultrasound-guided transbronchial needle aspiration. Methods This retrospective study included data of patients who underwent EBUS-TBNA with a 22-gauge needle made from either stainless steel (41 lesions, 121 punctures) or cobalt chromium (47 lesions, 145 punctures). Histological data per puncture, diagnostic yield per lesion, procedure time and complication rates were compared. Results There were no significant differences between the groups in the baseline characteristics of the patients or lesions or in the complication rates. The rate of diagnostic histological specimens in each sample (71.0% vs. 58.7%, P = 0.039), fewer samples with cartilage alone (1.4% vs. 6.6%, P = 0.047) and fewer samples containing cartilage (7.6% vs. 16.5%, P = 0.034) were seen in the cobalt chromium needle group than in the stainless steel needle group. In both groups, the rate of specimens that only contained blood clots in each sample and diagnostic yield per lesion were similar, but the procedure time was significantly shorter (22 min vs. 26 min, P = 0.007) in the cobalt chromium needle group. Conclusion Compared with stainless steel needles, cobalt chromium needle for EBUS-TBNA showed lower cartilage contamination and a higher ratio of obtaining diagnostic specimens in each sample. Bronchoscopists should consider using the optimal needle gauges and materials for collecting adequate specimens.

scholarly journals Utility and safety of cobalt chromium needles for endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective single-center study

2019 ◽  
Author(s):  
Keigo Uchimura ◽  
Kei Yamasaki ◽  
Sachika Hara ◽  
Takashi Tachiwada ◽  
Toshinori Kawanami ◽  
...  
Keyword(s):  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Complication Rates ◽  
Procedure Time ◽  
Cobalt Chromium ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Lymph Node Sampling ◽  
Single Center Study ◽  
Histological Data

Abstract Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard method for obtaining specimens of mediastinal and hilar lesions, and several types of needle of various sizes and materials are available. This study aimed to compare the utility and safety of two needles, cobalt chromium (CC) and stainless steel (SS), for EBUS-TBNA. Methods: This retrospective study included data of patients who underwent EBUS-TBNA with a 22-gauge needle made from either SS (38 patients, 121 punctures) or CC (39 patients, 145 punctures), and procedure time, histological data, complication rates were compared. Results: There were no significant differences between the groups in the baseline characteristics of the patients or lesions or in the complication rates. Although diagnostic yields in each patient who underwent EBUS-TBNA with the two needle types were similar, significantly shorter procedure time (22 min vs. 26 min, p = 0.007), diagnostic histologic sampling yield in each sample (71.0% vs. 58.7%, p = 0.039), fewer samples with cartilage alone (1.4% vs. 6.6%, p = 0.047) and fewer samples containing cartilage (7.6% vs. 16.5%, p = 0.034) were seen in the CC group compared with that in SS needle group. Conclusion: Compared with SS needles, CC needle for EBUS-TBNA showed significant shorter procedure time and higher ratio of getting diagnostic histological specimens in each sample. This might be because of better ability of CC needle to puncture through the trachea and bronchial cartilage to get appropriate lymph node sampling.

scholarly journals Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): Technical Updates and Pathological Yield

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2331
Author(s):  
Huzaifa A. Jaliawala ◽  
Samid M. Farooqui ◽  
Kassem Harris ◽  
Tony Abdo ◽  
Jean I. Keddissi ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Procedure Time ◽  
Ultrasound Guided ◽  
Benign Diseases ◽  
Transbronchial Needle Aspiration ◽  
Technical Aspects ◽  
Mediastinal Adenopathy ◽  
Number Of Passes

Since the endobronchial ultrasound bronchoscope was introduced to clinical practice, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the procedure of choice to sample hilar and mediastinal adenopathy. Multiple studies have been conducted in the last two decades to look at the different technical aspects of the procedure and their effects on the final cytopathological yield. In addition, newer modes of ultrasound scanning and newer tools with the potential to optimize the selection and sampling of the target lymph node have been introduced. These have the potential to reduce the number of passes, reduce the procedure time, and increase the diagnostic yield, especially in rare tumors and benign diseases. Herein, we review the latest updates related to the technical aspects of EBUS-TBNA and their effects on the final cytopathological yield in malignant and benign diseases.

Mediastinal Nodular Lymphocyte Predominant Hodgkin Lymphoma Achieved by Endoscopic Transesophageal Cryobiopsy

Respiration ◽  
2021 ◽  
pp. 1-5
Author(s):  
Zan-Sheng Huang ◽  
Dong Zhou ◽  
Jing Zhang ◽  
Wan-Lei Fu ◽  
Jing Wang ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Diagnostic Yield ◽  
Cancer Staging ◽  
Needle Aspiration ◽  
Sample Volume ◽  
Small Sample ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Initial Sampling

Guidelines have recommended endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided fine-needle aspiration biopsy as initial sampling approaches of mediastinal lymph nodes for lung cancer staging. However, the small sample volume might restrict the diagnostic utility of needle aspiration in certain mediastinal diseases. We have recently shown that transbronchial mediastinal cryobiopsy, which is capable of providing larger amounts of intact tissue, improves diagnostic yield in rare tumors and benign diseases compared to EBUS-TBNA. Here, we present a case of mediastinal nodular lymphocyte predominant Hodgkin lymphoma successfully diagnosed by endoscopic transesophageal cryobiopsy.

scholarly journals Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer

2015 ◽  
Vol 41 (3) ◽  
pp. 219-224 ◽  
Author(s):  
Sebastián Fernández-Bussy ◽  
Gonzalo Labarca ◽  
Sofia Canals ◽  
Iván Caviedes ◽  
Erik Folch ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Diagnostic Yield ◽  
Mediastinal Lymph Node ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Lymph Node Staging ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
The Mean

OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield for suspicious central pulmonary lesions and for mediastinal lymph node staging. The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for mediastinal lymph node staging in patients with suspected lung cancer. METHODS: Prospective study of patients undergoing EBUS-TBNA for diagnosis. Patients ≥ 18 years of age were recruited between July of 2010 and August of 2013. We recorded demographic variables, radiological characteristics provided by axial CT of the chest, location of the lesion in the mediastinum as per the International Association for the Study of Lung Cancer classification, and definitive diagnostic result (EBUS with a diagnostic biopsy or a definitive diagnostic method). RESULTS: Our analysis included 354 biopsies, from 145 patients. Of those 145 patients, 54.48% were male. The mean age was 63.75 years. The mean lymph node size was 15.03 mm, and 90 lymph nodes were smaller than 10.0 mm. The EBUS-TBNA method showed a sensitivity of 91.17%, a specificity of 100.0%, and a negative predictive value of 92.9%. The most common histological diagnosis was adenocarcinoma. CONCLUSIONS: EBUS-TBNA is a diagnostic tool that yields satisfactory results in the staging of neoplastic mediastinal lesions.

scholarly journals Utility of on-site evaluation of endobronchial ultrasound-guided transbronchial needle aspiration specimens

CytoJournal ◽  
2011 ◽  
Vol 8 ◽  
pp. 20 ◽  
Author(s):  
Adrienne Carruth Griffin ◽  
Lauren Ende Schwartz ◽  
Zubair W. Baloch
Keyword(s):  
Clinical Decision Making ◽  
Malignant Tumors ◽  
Diagnostic Yield ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Cytologic Diagnosis ◽  
Transbronchial Needle Aspiration ◽  
Site Evaluation

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an integral tool in the diagnosis and staging of malignant tumors of the lung. Rapid on-site evaluation (ROSE) of fine needle aspiration (FNA) samples has been advocated for as a guide for assessing the accuracy and adequacy of biopsy samples. Although ROSE has proven useful for numerous sites and procedures, few studies have specifically investigated its utility in the assessment of EBUS-TBNA specimens. The intention of this study was to explore the utility of ROSE for EBUS-TBNA specimens. Materials and Methods: The pathology files at our institution were searched for all EBUS-TBNA cases performed between January 2010 and June 2010. The data points included number of sites sampled per patient, location of site(s) sampled, on-site evaluation performed, preliminary on-site diagnosis rendered, final cytologic diagnosis, surgical pathology follow-up, cell blocks, and ancillary studies performed. Results: A total of 294 EBUS-TBNA specimens were reviewed and included in the study; 264 of 294 (90%) were lymph nodes and 30 of 294 (10%) were lung mass lesions. ROSE was performed for 140 of 294 (48%) specimens. The on-site and final diagnoses were concordant in 104 (74%) and discordant in 36 (26%) cases. Diagnostic specimens were obtained in 132 of 140 (94%) cases with on-site evaluation and 138 of 154 (90%) without on-site evaluation. The final cytologic diagnosis was malignant in 60 of 132 (45%) cases with ROSE and 46 of 138 (33%) cases without ROSE, and the final diagnosis was benign in 57 of 132 (47%) with ROSE and 82 of 138 (59%) without ROSE. A cell block was obtained in 129 of 140 (92%) cases with ROSE and 136 of 154 (88%) cases without ROSE. Conclusions: The data demonstrate no remarkable difference in diagnostic yield, the number of sites sampled per patient, or clinical decision making between specimens collected via EBUS-TBNA with or without ROSE. As a result, this study challenges the notion that ROSE is beneficial for the evaluation of EBUS-TBNA specimens.

scholarly journals Dexmedetomidine sedation for endobronchial ultrasound-guided transbronchial needle aspiration, a randomised controlled trial

2020 ◽  
Vol 6 (4) ◽  
pp. 00064-2020
Author(s):  
Ting-Yu Lin ◽  
Yu-Chen Huang ◽  
Chih-Hsi Kuo ◽  
Fu-Tsai Chung ◽  
Yu-Ting Lin ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Recovery Period ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Propofol Sedation ◽  
Arterial Blood ◽  
Patient Cooperation ◽  
Group D

Background and aimAppropriate sedation is important to the success of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Dexmedetomidine is a sedative agent that operates via the α2 adrenergic agonist, which provides sleep-like sedation with little respiratory suppression. This study compared the efficacy and safety of dexmedetomidine sedation with propofol in cases of EBUS-TBNA.MethodsPatients requiring EBUS-TBNA were randomly assigned dexmedetomidine sedation (D, n=25) or propofol sedation (P, n=25). Vital signs, diagnostic yield and the bispectral index (BIS) were recorded throughout the bronchoscopic procedure and recovery period. The tolerance and cooperation of the patients were evaluated using questionnaires.Measurements and resultsThe lowest mean arterial blood pressure in group D (79.2±9.9 versus 72.5±12.9 mmHg, p=0.049) exceeded that in group P, the lowest heart rate was lower (60.9±10.2 versus 71.4±11.8 beats·min−1, p=0.006) and the mean BIS during sedation was significantly higher (84.1±8.3 versus 73.6±5.7, p<0.001). Patients in group D were more likely to report perceiving procedure-related symptoms and express an unwillingness to undergo the bronchoscopy again, if indicated (41.1 versus 83.3%, p=0.007). One subject in group D aborted EBUS-TBNA due to intolerance. Many of the variables in the two groups were similar, including the proportion of hypoxaemic events, recovery times, patient cooperation and diagnostic yield.ConclusionsThe effects of dexmedetomidine on haemodynamics were in line with its pharmacodynamic features. Patients who received dexmedetomidine were more likely than those who received propofol to perceive the procedures. Overall, dexmedetomidine did not prove inferior to propofol sedation in terms of patient cooperation or diagnostic yield.

The Techniques of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

2011 ◽  
Vol 6 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Takahiro Nakajima ◽  
Kazuhiro Yasufuku
Keyword(s):  
Lymph Node ◽  
Diagnostic Yield ◽  
Mediastinal Lymph Node ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Lymph Node Staging ◽  
Ultrasound Guided ◽  
Surgical Biopsy ◽  
Transbronchial Needle Aspiration ◽  
High Diagnostic Yield

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality for mediastinal lymph node staging in lung cancer patients as well as for the diagnosis of mediastinal and hilar adenopathy. The high diagnostic yield of EBUS-TBNA for lymph node staging has been shown in systematic reviews and meta-analysis. It has attracted physicians and surgeons as an alternative modality to surgical biopsy for the assessment of patients with enlarged mediastinal and/or hilar lymph nodes. Cell blocks obtained by EBUS-TBNA can be applicable not only for pathologic diagnosis but also for further investigations such as immunohistochemistry and fluorescence in situ hybridization. In addition, samples obtained by EBUS-TBNA can also be used for molecular analysis. Unlike regular bronchoscopy, EBUS-TBNA uses the convex probe EBUS with an ultrasound probe on the tip of a flexible bronchoscope. It is important for the bronchoscopist to fully understand the mediastinal anatomy and be able to correlate it with the ultrasound images for a successful EBUS-TBNA. The dedicated transbronchial needle used for EBUS-TBNA is somewhat different from an ordinary transbronchial biopsy forceps. Training is mandatory for achieving high diagnostic yield without complications. The learning curve of EBUS-TBNA is different from each physician, and continuous training program will be needed for impartiality. This article explains the detailed techniques of EBUS-TBNA to master this innovative procedure.

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