scholarly journals Simultaneous amplification and testing method forMycobacterium tuberculosisrRNA to differentiate sputum-negative tuberculosis from sarcoidosis

2019 ◽  
Vol 316 (3) ◽  
pp. L519-L524 ◽  
Author(s):  
Qiu-Hong Li ◽  
Yuan Zhang ◽  
Meng-Meng Zhao ◽  
Ye Gu ◽  
Yang Hu ◽  
...  
Keyword(s):  
Predictive Value ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Sputum Smear ◽  
Transbronchial Needle Aspiration ◽  
Simultaneous Application ◽  
Testing Method ◽  
Biopsy Specimens ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Sensitivity Specificity

We use the simultaneous application and testing method to detect Mycobacterium tuberculosis rRNA (SAT-TB) with the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy specimens to differentiate sputum-negative tuberculosis from sarcoidosis. In the first part, we validated the SAT-TB on the bronchial or EBUS-TBNA biopsy specimens from sputum smear-positive pulmonary tuberculosis. In the second part, all EBUS-TBNA specimens for sputum smear-negative intrathoracic tuberculous lymphadenopathies or sarcoidosis were tested with the SAT-TB, acid-fast bacilli smear, and culture. In the 16 sputum-positive tuberculosis cases, 5 showed negative SAT (2 nontuberculous mycobacteria and 3 had anti-tuberculosis therapies previously); the remaining 11 were positive. Of the 41 sputum-negative tuberculosis cases in the second part, five other diseases were negative. In the remaining 36 cases, 27 sarcoidosis cases were negative; 7 in 9 with sputum-negative tuberculosis were positive (77.78%). In these 36 patients, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the SAT method were 77.78, 100, 100, 93.10, and 94.44%, respectively. The SAT distinguished sputum-negative tuberculosis from sarcoidosis significantly ( P < 0.0001) and identified cases with active M. tuberculosis as accurately as the conventional methods (κ = 0.912, P < 0.0001). We conclude that the SAT-TB may be an effective method for using biopsy specimens to differentiate sputum-negative tuberculosis from sarcoidosis.

scholarly journals Diagnostic yield of transbronchial needle aspiration for lymphoma

2016 ◽  
Vol 22 (3) ◽  
pp. 67
Author(s):  
B Sonnekus ◽  
J Steenkamp ◽  
M Louw ◽  
C F N Koegelenberg
Keyword(s):  
Predictive Value ◽  
Diagnostic Yield ◽  
Cost Effective ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Tracheobronchial Tree ◽  
Transbronchial Needle Aspiration ◽  
Predictive Values ◽  
Hilar Adenopathy ◽  
Sensitivity Specificity

<p>Background. Transbronchial needle aspiration (TBNA) is a minimally invasive bronchoscopic technique that is cost-effective and safe for diagnosing mediastinal and hilar adenopathy in lung cancer, other malignancies, sarcoidosis and infectious processes such as tuberculosis. Few studies have analysed the sensitivity, specificity and predictive values of TBNA for diagnosing lymphoma.</p><p>Objective. To evaluate the diagnostic yield of TBNA for diagnosing mediastinal and hilar adenopathy in suspected lymphoma.</p><p>Methods. We performed a retrospective analysis of collected data of patients with mediastinal and hilar adenopathy adjacent to the tracheobronchial tree detected by thoracic computed tomography, who underwent TBNA at Tygerberg Hospital between July 2010 and June 2013. We included 25 patients with suspected or proven lymphoma. Histology was used as the gold standard.</p><p>Results. Adequate samples for cytological evaluation were obtained for 22 (88%) patients. Cytological diagnosis was possible for 8 (32%). For 17 (68%) who could not be diagnosed by TBNA alone, histology provided final diagnosis. Rapid on-site examination (ROSE) was performed in 23 (92%). In 17/23 (74%) cases, these had similar results to formal cytology. Only 4 (16%) had flow cytometry requested. Twelve (48%) had lymphoma confirmed on histology. TBNA cytology had 100% specificity and positive predictive value for suspicion of lymphoma. Sensitivity was 33% and negative predictive value 62%.</p><p>Conclusion. TBNA is an appropriate first-line diagnostic procedure in evaluating mediastinal and hilar lymphadenopathy in suspected lymphoma. Biopsy should be the immediate second-line procedure when ROSE/cytology is suspicious of lymphoma or shows atypical cells. Patients with negative TBNA cytology, but high clinical or radiological suspicion of lymphoma, should be further investigated.</p>

scholarly journals Slow-pull capillary technique versus suction technique in endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing diseases involving hilar and mediastinal lymph node enlargement

2020 ◽  
Vol 14 ◽  
pp. 175346662090703 ◽  
Author(s):  
Xin He ◽  
Yanjun Wu ◽  
Haoyan Wang ◽  
Ganggang Yu ◽  
Bo Xu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Diagnostic Accuracy ◽  
Mediastinal Lymph Node ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Tissue Core ◽  
Sensitivity Specificity ◽  
Diagnosis Of Diseases

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely used, safe, and accurate technique for obtaining pathological specimens to be used in the diagnosis of diseases involving lung hilar and mediastinal lymph node (LN) enlargement. However, application of the suction technique during EBUS-TBNA remains controversial. In addition, the effectiveness of the slow-pull capillary technique for the diagnosis of pancreatic masses was recently reported. The aim of this study was to compare the diagnostic accuracy of EBUS-TBNA using these two techniques. Methods: The accuracy, sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and availability of tissue cores of the suction and slow-pull capillary techniques were studied retrospectively in patients who underwent EBUS-TBNA for the diagnosis of diseases involving lung hilar and mediastinal LN enlargement. Results: A total of 97 patients with hilar and mediastinal LN enlargement underwent EBUS-TBNA; 30 patients underwent the suction technique, 56 patients underwent the slow-pull capillary technique, 5 patients underwent both techniques, and 6 patients had failed operations. The accuracy, sensitivity, specificity, NPV, PPV, and the number of tissue cores obtained with the suction and slow-pull capillary techniques were 66.67% versus 85.71% ( p = 0.039), 43.75% versus 85.42% ( p < 0.001), 92.86% versus 87.5% ( p > 0.05), 59.09% versus 50% ( p > 0.05), 87.5% versus 97.62% ( p > 0.05), and 19 versus 50 ( p = 0.004), respectively. In both univariate and multivariate analyses, the acquisition of tissue core was significantly associated with the diagnostic accuracy of EBUS-TBNA. Moreover, the slow-pull capillary technique was significantly associated with the acquisition of tissue core in EBUS-TBNA. There were no significant differences between the two groups in the blood contamination of samples. Conclusions: Use of the slow-pull capillary technique in EBUS-TBNA can significantly increase the accuracy related to the diagnosis of diseases involving hilar and mediastinal LN enlargement by improving the acquisition of tissue core. The reviews of this paper are available via the supplemental material section.

scholarly journals Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Cytological Smears and Cell Blocks: A Single-Institution Experience

Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 19 ◽  
Author(s):  
Marius Žemaitis ◽  
Greta Musteikienė ◽  
Skaidrius Miliauskas ◽  
Darius Pranys ◽  
Raimundas Sakalauskas
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Medical Documentation ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration

Background and Objective: Endobronchial ultrasound (EBUS) is a minimally invasive endobronchial technique, which uses ultrasound along with a bronchoscope to visualize the airway wall and structures that are adjacent to it. Indications for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are samplings of mediastinal, hilar lymph nodes, and tumors adjacent to airway walls. EBUS-TBNA has been used in our clinic since 2009. The aim of the study is to evaluate the sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy of cytological and histological specimens, and the safety of EBUS-TBNA in an unselected patient population that has been referred to our hospital. Materials and Methods: We have retrospectively analyzed the medical documentation of 215 patients who had EBUS-TBNA performed in our clinic from April 2009 to February 2014. Results: There were 215 patients who underwent EBUS-TBNA. A total of 296 lymph nodes were sampled. EBUS-TBNA was diagnostic in 176 (81.9%) cases of cytological, 147 (68.4%) cases of histological, and 191 (88.9%) cases of the combined evaluation. In the lung cancer patients, EBUS-TBNA cytology had a sensitivity of 72.9% and histology of 72.9%, and in the sarcoidosis group, it had a cytology of 55.8% and histology of 64.5%. As all positive cytology and histology specimens were assumed to be true positive, specificity and positive predictive value (PPV) were 100%. The sensitivity and diagnostic accuracy was significantly higher when cytology and histology specimens were combined, compared with cytology or histology results evaluated separately (p < 0.05) (for lung cancer 84.1% and for sarcoidosis 78.8%). The sensitivity and diagnostic accuracy of EBUS-TBNA procedures increased significantly over time, with increased experience. There were no complications with EBUS-TBNA in our clinical practice. Conclusions: EBUS-TBNA had a high diagnostic yield and was safe in the diagnosis of lung cancer and sarcoidosis. It was most informative when cytology and histology were combined. The informative value of EBUS-TBNA histology increased with our experience.

scholarly journals Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

2021 ◽  
Author(s):  
Jing Huang ◽  
Yuan Lu ◽  
Xihua Wang ◽  
Xiaoli Zhu ◽  
Ping Li ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Transbronchial Needle Aspiration ◽  
Sensitivity Specificity ◽  
Malignant Lymph Nodes

Abstract Background: Endobronchial ultrasound (EBUS) elastography has been applied in EBUS-guided transbronchial needle aspiration (EBUS-TBNA) to identify malignant lymph nodes based on the tissue stiffness. Rapid onsite cytological evaluation (ROSE) has been widely used for onsite evaluation of the adequacy of the samples and guiding the sampling during EBUS-TBNA. The aim of the study is to investigate the diagnostic value of combined EBUS elastography and ROSE in evaluating of mediastinal and hilar lymph nodes status.Methods: A retrospective chart review was performed from December 2018 to September 2020. Patients’ demographic, EBUS elastography score, ROSE, pathologic and clinical outcomes were collected. The EBUS elastography scores were classified as follows: Type 1, predominantly non-blue; Type 2, partially blue and partially non-blue; Type 3, predominantly blue. Receiver operating characteristic (ROC) curve was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio among EBUS elastography, ROSE, and EBUS combined with ROSE groups for evaluation of malignant lymph nodes.Results: A total of 247 patients (345 lymph nodes) were included in our study. The sensitivity and specificity of EBUS elastography group in the diagnosis of malignant lymph nodes were 90.51% and 57.26%, respectively. The sensitivity and specificity in the ROSE alone group were 96.32% and 79.05%, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of EBUS elastography combined with ROSE group were 86.61%, 92.65%, 11.78, and 0.14, respectively, and the area under curve was 0.942.Conclusions: The combination of EBUS elastography and ROSE significantly increased the diagnostic value of EBUS-TBNA in evaluating mediastinal and hilar lymph nodes status.

scholarly journals Endobronchial Ultrasound Features for Evaluation of Mediastinal and Hilar Lymph Nodes

2021 ◽  
Author(s):  
Lingling Pang ◽  
Shenchun Zou ◽  
Xueping Liu ◽  
Yingqi Fan ◽  
Ying Shi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
Multivariate Logistic Regression Analysis ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Operating Characteristics ◽  
Transbronchial Needle Aspiration ◽  
Round Shape

Abstract Background. The aim of the study was to evaluate the utility of Endobronchial ultrasound (EBUS) features included elastography and B-mode features for differentiating malignant from benign lymph nodes(LNs). Methods. 84 patients with 151 enlarged mediastinal and hilar LNs underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) were involved in the retrospective study from 1 January 2019 to 31 December 2019. Scores of EBUS elastography, EBUS B-mode features and final pathological results were recorded. Receiver operating characteristics, univariate and multivariate logistic regression analysis were used to evaluate the diagnostic yield of elastography and B-mode features for malignant LNs. Results. Total 84 patients of 151 LNs were enrolled in the single center retrospective study, which included 108 malignant nodes and 43 benign nodes obtained from 59/25 patients respectively. EBUS elastography score 4-5 differentiated malignant LNs from benign nodes with sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy 85.05%, 77.27%, 90.10%, 71.0% and 82.23% respectively. EBUS B-mode features round shape, heterogenenous echogenicity and absence of CHS showed statistical diagnostic yield by multivariate logistic analysis. ROC analysis suggested the combined AUC for elastography, round shape, absence of CHS and hetergeneous echogenicity was 0.849. Conclusions. EBUS features are effective for differentiating between benign and malignant LNs. This study was approved by the Ethics Committee of Qingdao medical college affiliated Yantai Yuhuangding Hospital (NO. 2014-111).

Endobronchial ultrasound-guided biopsy for evaluation of suspected lung cancer

2019 ◽  
Vol 27 (6) ◽  
pp. 471-475 ◽  
Author(s):  
Dwight Harris ◽  
Sibu Saha
Keyword(s):  
Lung Cancer ◽  
Sensitivity And Specificity ◽  
Cancer Diagnosis ◽  
Predictive Value ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Invasive Technique ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Lung Cancer Diagnosis

Purpose Historically, mediastinoscopy has been the gold standard for lung cancer diagnosis and staging, but mediastinoscopy has many limitations including sensitivity, the limited number of lymph node levels that can be sampled, and safety. Endobronchial ultrasound-guided transbronchial needle aspiration is a relatively new and less-invasive technique being used for lung cancer screening. Many studies have reported that it has similar sensitivity and specificity compared to mediastinoscopy, with a significantly lower complication rate. We performed this review to determine our institution’s experience with endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer diagnosis and staging. Methods We reviewed the last 150 patients with suspected lung cancer who underwent endobronchial ultrasound-guided transbronchial needle aspiration procedures in our institution from May 26, 2016 to August 31, 2017. Results Ninety-seven of the 150 patients had a confirmed diagnosis of malignancy. Forty patients had a diagnosis other than cancer, and 13 had incomplete information or were lost to follow-up. Endobronchial ultrasound-guided transbronchial needle aspiration was correct in diagnosing malignancy or excluding malignant lymph nodes in 92 of the 97 patients with malignancy. Overall, the sensitivity, specificity, positive-predictive value, and negative-predictive value was 94.0%, 100.0%, 100.0%, and 91.5%, respectively. Only 3 complications were reported: 2 patients suffered minor bleeding, and one suffered major bleeding that resulted in cardiac arrest. Conclusions Real-time endobronchial ultrasound-guided transbronchial needle aspiration has a similar sensitivity and specificity to mediastinoscopy in diagnosing malignancy, with fewer complications and more financial benefit.

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