scholarly journals Applicability of Endobronchial Ultrasound and Virtual Bronchoscopic Navigation Combined with Rapid On-Site Evaluation in Diagnosing Peripheral Lung Lesions

2021 ◽  
Author(s):  
Jia-Chao Qi ◽  
Liping Liao ◽  
Zhiwei Zhao ◽  
HuiXue Zeng ◽  
Tiezhu Wang ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Endobronchial Ultrasound ◽  
Average Procedure ◽  
Procedure Time ◽  
Significant Difference ◽  
Positive Rate ◽  
Site Evaluation ◽  
Medical University ◽  
The Impact ◽  
Average Procedure Time

Abstract Background To investigate the value of endobronchial ultrasound (EBUS) and virtual bronchoscopic navigation (VBN) combined with rapid on-site evaluation (ROSE) in diagnosing peripheral pulmonary lesions (PPLs). Methods Between January 1st 2019 to September 1st 2021, EBUS and VBN examination were performed in 250 consecutive patients with PPLs who were admitted to Zhangzhou Affiliated Hospital of Fujian Medical University (Fujian, China). Finally, 198 eligible patients were randomly divided into ROSE group (100 cases) and non-ROSE group (98 cases). The diagnostic yield of brushing and biopsy, the complications, the procedure time, the diagnosis time and expense during diagnosis were analyzed. Results In the ROSE group, the positive rate of EBUS brushing and biopsy were 68%, 84%, repectively. The average procedure time and diagnosis time were 18.6 ± 6.8 min, 3.84 ± 4.28 days, repectively, and the average expense was 4093.15 ± 4494.67 yuan. In the controls, the positive rate of brushing and biopsy were 44%, 74%, repectively. The average procedure time and diagnosis time were 15.4 ± 5.7 min, 6.46 ± 3.66 days, repectively. And the average expense during diagnosis was 6420.28 ± 4541.33 yuan. There was significant difference in the positive rate of EBUS brushing and biopsy, diagnosis time and expense during diagnosis between both groups. And no significant difference was observed in the complications and the procedure time. Additionally, the impact of ROSE on diagnostic yield in right upper lobe and the size of lesion ≤2 cm in diameter was significant. Conclusion In combination with ROSE, EBUS could significantly improve the positive rate of diagnosing PPLs, shorten diagnosis time and reduce expense during diagnosis. ROSE will be of great importance in the diagnosis of PPLs and medical resource.

scholarly journals Improved diagnostic yield of transbronchial lung biopsy in peripheral pulmonary lesions using a combination of endobronchial ultrasound and rapid on-site evaluation

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199953
Author(s):  
Chunhua Xu ◽  
Yan Wang ◽  
Wei Wang ◽  
Qi Yuan ◽  
Hui di Hu ◽  
...  
Keyword(s):  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Transbronchial Lung Biopsy ◽  
Endobronchial Ultrasound ◽  
Procedure Time ◽  
Cytologic Diagnosis ◽  
Pulmonary Lesions ◽  
Procedural Complications ◽  
Site Evaluation ◽  
Peripheral Pulmonary Lesions

Objectives To evaluate the value of rapid on-site evaluation (ROSE) during radial probe endobronchial ultrasound transbronchial lung biopsy (rpEBUS-TBLB) for peripheral pulmonary lesions (PPLs). Methods One hundred and six patients with PPLs who received rpEBUS-TBLB were enrolled in this study. One specimen was immediately examined by ROSE and the other was sent to the central laboratory for cytologic diagnosis. The results of ROSE were compared with those of pathological diagnosis. Results The diagnostic accuracy, sensitivity, and specificity of ROSE during rpEBUS-TBLB for PPLs were 82.1%, 89.6%, and 77.1%, respectively. The procedure times and number of biopsies were less for procedures when ROSE was positive compared with those when ROSE was negative (procedure time: 20.5 ± 7.9 vs. 28.3 ± 7.6 minutes; number of biopsies: 1.6 ± 0.9 vs. 2.8 ± 0.6 times). No serious procedural complications were observed. Conclusions ROSE has value for diagnosing PPLs during rpEBUS. It can reduce procedure time, number of biopsies, and complications. ROSE combined with rpEBUS is an effective and safe method for the diagnosis of PPLs.

scholarly journals Impact of Remote Teaching on Japanese Medical University Students' Sleeping Habits : a Longitudinal Study

2021 ◽  
Author(s):  
Reiko Hori ◽  
Eiji Shibata ◽  
Iwao Okajima ◽  
Masahiro Matsunaga ◽  
Tomohiro Umemura ◽  
...  
Keyword(s):  
University Students ◽  
Sleep Duration ◽  
Sleep Problems ◽  
Significant Difference ◽  
Delayed Sleep Phase ◽  
The Mean ◽  
Delayed Sleep ◽  
Sleeping Habits ◽  
Medical University ◽  
The Impact

Abstract Background: The coronavirus disease 2019 (COVID-19) pandemic has changed our daily life. Owing to the imposed restrictions, many educational facilities have introduced remote teaching. This study aims to understand the impact of remote teaching on Japanese university students' sleeping habits.Methods: The participants were medical university students. We used data from an ongoing longitudinal sleeping habits survey. For 684 participants who enrolled in the university during 2018–2020, multilevel analyses of sleep duration during weekdays and weekends across 3 years were conducted, adjusting for gender, grade, place of stay, sleep problems and lifestyle habits. Results: Among the participants, 356 male (mean ± standard deviation: 22 ± 3, 18–37 years old) and 288 female (22 ± 3, 18–32 years old) students in 2018, 365 male (24 ± 3,18–36 years old) and 284 female (22 ± 2, 18–33 years old) students in 2019, and 226 male (20 ± 3,18-36 years old) and 167 female (21 ± 2, 18–34 years old) students in 2020 answered the questionnaire. The mean sleep duration during weekdays (in minutes) was 407.6 ± 60.3 in 2018, 406.9 ± 63.0 in 2019, and 417.3 ± 80.9 in 2020. The mean sleep duration during weekends (in minutes) was 494.5 ± 82.5 in 2018, 488.3 ± 87.9 in 2019, and 462.3 ± 96.4 in 2020. The analysis showed that sleep duration during weekdays was associated with the place of stay and survey year. Moreover, students reported significantly longer sleep duration during weekdays in 2020 than 2019, but no significant difference in sleep duration between 2018 and 2019. Sleep duration during weekends was found to be associated with the survey year, gender and always doing something before going to bed. Sleep duration during weekends was shorter in 2020 than 2019 and longer in male students and students who always do something before going to bed. Ten students were reported to have a delayed sleep phase in 2020. Conclusions: Students' sleep duration increased during weekdays and decreased during weekends in 2020. This difference could be explained by the COVID-19 pandemic and the introduction of remote teaching.

scholarly journals Biological characteristics of rt181T/sW172* HBV are similar among distinct genotypes

2020 ◽  
Author(s):  
Wang Huaqiang ◽  
Ai Jun ◽  
Zhang Jiajuan ◽  
Zheng Wenkai ◽  
Wang Maorong ◽  
...  
Keyword(s):  
Hbv Dna ◽  
Biological Characteristics ◽  
Wild Type ◽  
Hbv Genotypes ◽  
Mutational Pattern ◽  
Significant Difference ◽  
Positive Rate ◽  
The Impact ◽  
Type Strains ◽  
Genotype A

Abstract Background: The influence of genotypes on disease progression and clinical outcome of HBV infection is noted. The impact of HBV genotypes on rtA181T/sW172* mutation remains unclear. Patients and Methods: Clinical characteristics of 69 patients with rtA181T/sW172* mutation and 39 patients with rtA181V mutation were analyzed in this study. Fifteen serum specimens with rtA181T/sW172* mutation from different genotypes were collected for cloning and sequence analysis. HBV markers in HepG2 cells encoding different proportions of rtA181T/sW172* mutation and wild type strains were detected in genotype A, B, C and D, respectively.Results: No statistically difference was detected between rtA181T and rtA181V group regarding mean age, sex ratio, liver functions, HBV DNA load and HBeAg positive rate, except for HBsAg level (rtA181T group = 3.07±0.54 lg IU/ml vs rtA181V group = 3.29±0.43 lg IU/ml, P=0.037). Among 69 patients with rtA181T/sW172* mutation, HBV genotypes B and C accounted for 17.0% and 83.0%, respectively. The rate of genotype B was lower in rtA181T group (10.1%) than that in rtA181V group (29.7%), whereas genotype C was higher in rtA181T group (89.9%) than that in rtA181V group (70.3%). HBV rtA181T/sW172* mutant coexisted with wild type strains, accounted for 25% to 90% in all HBV strains. The distribution proportion showed no statistical difference between genotype B and C (59.2%±24.3% vs. 61.2%±19.1% , P=0.86). In transfection experiments, the level of HBV DNA was the highest for genotype B, while HBsAg was expressed in the highest level for genotype A. HBsAg and virus particle were barely detected in the supernatants of rtA181T/sW172* HBV clones in all genotypes. As the proportion of wild type HBV plasmid increased, deficiency of rt181T/sW172* mutation was complemented in all genotypes. No significant difference of the relative expression was found among distinct genotypes (P >0.05).Conclusions: HBV rtA181T/sW172* mutational pattern may be influenced by genotypes, but biological characteristics of this mutation is similar among distinct genotypes.

scholarly journals Values of different specimen preparation methods for the diagnosis of lung cancer by endobronchial ultrasound guided transbronchial needle aspiration

2019 ◽  
Author(s):  
YouZu Xu ◽  
Jian Lin ◽  
meifang chen ◽  
HaiHong Zheng ◽  
JiaXi Feng
Keyword(s):  
Lung Cancer ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Hilar Lymph Node ◽  
Treatment Type ◽  
Significant Difference ◽  
Positive Rate ◽  
Diagnosis Of Lung Cancer

Abstract Background: Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has been become an important procedure for the diagnosis and staging of lung cancer. Our research identified the effects of different pathological preparation on the diagnosis of lung cancer for specimens obtained by biopsy. Methods: Patients were clinically considered if lung cancer was accompanied by mediastinal or hilar lymph node enlargement between March 2014 and November 2017. Specimens obtained by EBUS-TBNA were treated by three methods: traditional smear cytology, liquid-based cytology (LBC) and histopathology. Results: Of a total of 154 puncture sites from 153 patients, the total positive rate of combination for the three pathological treatment types (histopathology, direct traditional smear, and LBC) was 77.3%. The diagnostic positive rate for histopathology was 68.6%, direct traditional smear was 65.6%, and LBC was 60.4%; there was no significant differences among the three single pathological treatment types (P=0.29), but there was a statistically significant difference between the combination of three treatments and any single pathological treatment type (P=0.01). The diagnostic sensitivities of histopathology combined with traditional smear and histopathology combined LBC were 94.4% and 92.8%, respectively, the specificities and PPVs were both 100%, and the diagnostic accuracies were 95.5% and 94.2%, respectively; the sensitivities, specificities and diagnostic accuracies above were all higher than those of single specimen treatment and lower than those of the three combined. Conclusion: When EBUS-TBNA is used for the diagnosis and staging of lung cancer, the use of histopathological sections combined with direct cytological smear should be sufficient and is the most economical choice.

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 Radial endobronchial ultrasound-guided transbronchial biopsy for peripheral pulmonary malignancy: biopsy- or brushing-first?

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chun-Ta Huang ◽  
Yi-Ju Tsai ◽  
Chao-Chi Ho ◽  
Chong-Jen Yu
Keyword(s):  
Diagnostic Yield ◽  
Transbronchial Biopsy ◽  
Endobronchial Ultrasound ◽  
Current Evidence ◽  
Diagnostic Strategy ◽  
Safety Signal ◽  
Pulmonary Lesions ◽  
Bronchial Brushing ◽  
Peripheral Pulmonary Lesions ◽  
The Impact

Abstract Background Radial endobronchial ultrasound (R-EBUS)-guided transbronchial biopsy (TBB) is a common diagnostic modality for peripheral pulmonary lesions; however, there is uncertainty about the optimal sequence of TBB and bronchial brushing during the procedure. Thus, we aimed to investigate whether a biopsy-first or brushing-first strategy confers a better diagnostic yield and safety signal for R-EBUS-guided procedures for peripheral pulmonary malignancy. Methods From January 2017 to June 2018, consecutive patients referred for R-EBUS-guided TBB and bronchial brushing of peripheral pulmonary lesions and with a final malignant diagnosis were included. Patients were placed in a biopsy-first (biopsy followed by brushing) or a brushing-first (brushing followed by biopsy) group. The outcomes of interest were the diagnostic yield and complication profile of the procedures. Multivariate logistic regression and subgroup analysis were used to assess the impact of the procedure strategy. Results A total of 438 patients were included and the diagnostic yield of R-EBUS-guided TBB plus brushing for peripheral pulmonary malignancy was 73%. The diagnostic yield was associated with the solid lesion appearance (odds ratio [OR] 2.01; 95% confidence interval [CI] 1.08–3.75) and R-EBUS probe position within the lesion (OR 1.92; 95% CI 1.08–3.42), and the yield rates were comparable between the biopsy-first and brushing-first strategies. Moreover, the safety signal did not differ between the two groups. Conclusions The two procedure strategies were indistinguishable in terms of diagnostic efficacy and adverse events for patients with peripheral pulmonary malignancy. Current evidence indicates that in patients with peripheral pulmonary lesions suspected of being malignant, either biopsy-first or brushing-first is a viable and acceptable diagnostic strategy during R-EBUS-guided procedures.

scholarly journals The Utility of Rapid On-Site Evaluation on Endobronchial Ultrasound Guided Transbronchial Needle Aspiration: Does It Make a Difference?

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Raymond W. M. Wong ◽  
Alesha Thai ◽  
Yet H. Khor ◽  
Kerryn Ireland-Jenkin ◽  
Celia J. Lanteri ◽  
...  
Keyword(s):  
Potential Benefit ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Cell Block ◽  
Procedure Time ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Site Evaluation ◽  
Austin Health

The purpose of this study was to assess the efficacy of using rapid on-site evaluation (ROSE) for samples taken during endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) at Austin Health, Victoria. This was compared to data collected for cases performed without ROSE. A retrospective analysis was conducted on 188 consecutive patients who underwent EBUS-TBNA from May 2012 to July 2014 whose data was collected prospectively at the time of the procedure. The presence of a cytologist during ROSE resulted in a significant reduction in the number of lesions sampled [mean: 1.5 ± 0.7 (1, 4) versus 1.9 ± 0.8 (1, 4), P = 0.0020] and the number of TBNAs required per case [mean: 3.6 ± 1.4 (1, 8) versus 4.2 ± 1.5 (1, 8), P = 0.0017]. This could potentially result in a shorter procedure time and, ultimately, a reduction in complication rate. The quality of the samples obtained during EBUS-TBNA with ROSE was higher. A larger proportion of samples yielded a satisfactory cell block allowing the potential benefit of additional pathology testing including immunohistochemistry and molecular pathology. In summary, the use of ROSE during EBUS-TBNA was superior to off-site cytological assessment of bronchoscopy specimens.

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 < 0.05). However, we found no significant improvement in terms of diagnostic yield for endoscopically visible malignancy (95.2% vs. 91.2%, P > 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 < 0.05), 0.728 (P < 0.05) and 0.940 (P < 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.

scholarly journals 397 Impact of COVID-19 on Theatre Utility

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
C Luney ◽  
C Little
Keyword(s):  
Elective Surgery ◽  
Time Interval ◽  
Electronic Database ◽  
Procedure Time ◽  
Excessive Heat ◽  
Total Procedure Time ◽  
Significant Difference ◽  
The Impact ◽  
Level 2 ◽  
Total Procedure

Abstract Introduction Covid-19 has significantly impacted the environment in which surgeons operate. Level-2 PPE is worn in our orthopaedic theatres, with increased time taken for simple tasks due to claustrophobia, excessive heat, and difficulties in communication due to masks, including donning and doffing. We sought to determine the impact of Covid-19 on theatre utility. Method 8week period during Covid-19 was reviewed for semi-elective orthopaedic surgery. Pre-Covid-19 case controls for age, procedure and ASA were identified. Electronic database was used to determine total time in theatre complex, time taken for anaesthesia, total procedure time, and time taken for patient to leave the theatre. Results 27patients undergoing semi-elective surgery during Covid-19 pandemic and 27-matched controls from before pandemic were identified. No statistically significant difference in procedural or anaesthetic time. Significant difference in time interval between cases (14minutes pre-Covid-19 v 58minutes during Covid-19; p < 0.05). Mean theatre start times are 51minutes later during Covid-19. Conclusions Procedural times of surgery have not significantly increased, however the time between cases has increased; resulting in a decrease in overall theatre complex utility and direct impact on future costing.

scholarly journals Diagnostic Value of Virtual Bronchoscopic Navigation Combined With Endobronchial Ultrasound Guided Transbronchial Lung Biopsy for Peripheral Pulmonary Lesions

2021 ◽  
Vol 20 ◽  
pp. 153303382198999
Author(s):  
Chunhua Xu ◽  
Yan Wang ◽  
Li Li ◽  
Qi Yuan ◽  
Yuchao Wang ◽  
...  
Keyword(s):  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Operation Time ◽  
Transbronchial Lung Biopsy ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Pulmonary Lesions ◽  
X Ray ◽  
Significant Difference ◽  
Peripheral Pulmonary Lesions

Objective: X-ray guided transbronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) can improve the diagnostic yield of peripheral pulmonary lesions (PPLs), but it needs special requirements. The purpose of this study was to investigate the clinical value of virtual bronchoscopy navigation (VBN) combined with EBUS-TBLB in the diagnosis of PPLs without X-ray guidance. Methods: The 105 patients with PPLs underwent EBUS-TBLB with or without VBN randomly. The diagnostic yield, the operation time and complications were evaluated in the 2 groups. Results: No significant difference was found between the VBN+EBUS group and the EBUS group (76.0% vs. 65.5%, P = 0.287). The operation time of VBN+EBUS group was significantly shorter than that of EBUS group (20.6 ± 12.8 min vs. 28.6 ± 14.3 min, P = 0.023). No severe procedure related complications occurred. Conclusions: VBN can shorten the operation time. The combination of VBN and EBUS-TBLB is a safe and effective diagnosis technique for PPLs.

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