scholarly journals Diagnostic Value of Bronchoscopy for Peripheral Metastatic Lung Tumors

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 375
Author(s):  
Yoshie Tsujimoto ◽  
Yuji Matsumoto ◽  
Midori Tanaka ◽  
Tatsuya Imabayashi ◽  
Keigo Uchimura ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Lung Metastases ◽  
Diagnostic Yield ◽  
Multivariable Analysis ◽  
Diagnostic Value ◽  
Lung Tumors ◽  
Lung Abscess ◽  
Endobronchial Ultrasound ◽  
Significant Difference ◽  
Metastatic Lung

Although lungs are one of the most frequent sites of metastasis for malignant tumors, little has been reported about the value of bronchoscopy for lung metastases presenting with peripheral pulmonary lesions (PPLs). This retrospective cohort study investigated the diagnostic value of bronchoscopy for peripheral metastatic lung tumors. Consecutive patients who underwent diagnostic bronchoscopy with radial endobronchial ultrasound for PPLs and were finally diagnosed with metastatic lung tumors from April 2012 to March 2019 were included. We analyzed 235 PPLs, with a median size of 18.8 mm. The overall diagnostic yield was 76.6%. In a multivariable analysis, large lesion size (>20.0 mm vs. <20.0 mm: 87.6% vs. 67.7%, p = 0.043, OR = 2.26), inner location (inner 2/3 vs. outer 1/3: 84.8% vs. 69.1%, p = 0.004, OR = 2.79), and visibility on radiography (visible vs. invisible: 83.2% vs. 56.1%, p = 0.015, OR = 3.29) significantly affected the diagnostic yield. Although a positive bronchus sign tended to have a higher yield, no significant difference was observed (81.8% vs. 70.6%, p = 0.063). Only one case of lung abscess was observed, with no serious complications. In conclusion, bronchoscopy is a valuable technique for peripheral metastatic lung tumors, with good diagnostic accuracy and safety.

scholarly journals New Approaches to the Surgical Treatment of Lung and Bronchial Tumors in Children

2021 ◽  
Vol 15 ◽  
pp. 311-317
Author(s):  
Oleg V. Bilokon ◽  
Elen V. Shaida ◽  
Petro P. Sokur ◽  
Borys O. Kravchuk
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Lung Metastases ◽  
Case Reports ◽  
Lung Tumors ◽  
Primary Tumors ◽  
Surgical Interventions ◽  
Pulmonary Lesions ◽  
Tissue Welding ◽  
Metastatic Lung

Today, it is relevant to search for new, better methods of surgical treatment of tumors and organ-preserving and video-assisted surgery is gaining more and more popularity. The aim of the study was to improve the results of surgical treatment of children with primary and secondary (metastatic) lung tumors using high-frequency live tissue welding (HF LTW) in order to increase the treatment effectiveness. Novelty of the study lies in the expanding the knowledge of the new researched method, for enhancement of survivability relatively to chemotherapy and radiation methods, that are studied in the previous works. Advantages of the introduced method are bloodless, fast, low traumatic operations 103 case reports in children with primary and metastatic lung tumors were analyzed, including 34 patients with benign and malignant lung tumors and 69 children with metastatic bronchial and pulmonary lesions undergoing treatment from 2002 to 2018 were examined. Benign lung tumors were diagnosed in 17 patients. Malignant tumors were observed in 17 patients, including 11 lung carcinoid tumors. Metastatic bronchial and pulmonary lesions most often occurred with osteosarcoma (28) and nephroblastoma (17). In 34 children with primary tumors, 37 were undergone surgical interventions. Most often, atypical resection was used – 16 (43.3%), in particular, with carcinoid – in 7 (43.8%) patients and with hamartoma – in 4 (25%) patients. In metastatic lesions, in most cases, the same resection was performed. From 58 resections 25 (43%) were performed for osteosarcoma and 15 (26%) for nephroblastoma. The HF LTW method was used in 29 patients for benign and malignant primary tumors and in 62 (73%) surgical procedures for lung metastases to remove a tumor, vascular coagulation and sealing of the lung tissue. Using HF LTW surgical operations of different directions and volumes can be performed effectively in benign, malignant and metastatic bronchial and pulmonary lesions in children.

scholarly journals Usefulness of virtual bronchoscopic navigation combined with radial endobronchial ultrasound for peripheral pulmonary lesions

2020 ◽  
Author(s):  
chunhua xu ◽  
Wei Wang ◽  
YuChao Wang ◽  
Qi Yuan ◽  
ChuanZhen Chi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Yield ◽  
Operation Time ◽  
Diagnostic Value ◽  
Endobronchial Ultrasound ◽  
Effective Technique ◽  
Pulmonary Lesions ◽  
Significant Difference ◽  
Peripheral Pulmonary Lesions

Abstract Background: This study aimed to evaluate the diagnostic value of virtual bronchoscopic navigation combined with radial endobronchial ultrasound for peripheral pulmonary lesions (PPLs). Methods: The 105 patients with PPLs identified by computed tomography in Nanjing Brain Hospital underwent radial endobronchial ultrasound (R-EBUS) with or without virtual bronchoscopic navigation (VBN) randomly from January 2015 to December 2017. The diagnostic yield, operation time and complications were evaluated in the two groups. Results: There was no significant difference in the diagnostic yield between the VBN+R-EBUS group and the R-EBUS group (76.0% vs. 65.5%, P =0.287). The operation time in VBN+R-EBUS group was less than that in R-EBUS group (20.6±12.8 min vs. 28.6±14.3 min, P =0.016). No severe procedure related complications such as pneumothorax and hemoptysis were observed. Conclusions: VBN cannot improve the diagnostic yield, but it can shorten the operation time. The VBN combined with R-EBUS is a safe and effective technique for PPLs.

scholarly journals Diagnostic Value of a New Cryoprobe for Peripheral Pulmonary Lesions: A Prospective Study

2021 ◽  
Author(s):  
Midori Tanaka ◽  
Yuji Matsumoto ◽  
Tatsuya Imabayashi ◽  
Takuya Kawahara ◽  
Takaaki Tsuchida
Keyword(s):  
Prospective Study ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Lesion Size ◽  
Endobronchial Ultrasound ◽  
Pulmonary Lesions ◽  
Single Use ◽  
Peripheral Pulmonary Lesions ◽  
A Prospective Study ◽  
Established Technique

Abstract Background: Cryobiopsy is an established technique that yields larger and higher-quality samples than does a forceps biopsy. However, it remains underutilised in the diagnosis of peripheral pulmonary lesions (PPLs), mainly because of difficulties in handling conventional cryoprobes. A recently introduced single-use cryoprobe with a smaller diameter and more flexibility than conventional ones may improve its diagnostic ability for PPLs. We conducted this prospective study to evaluate the feasibility of transbronchial cryobiopsy in the diagnoses of PPLs, using a new 1.7-mm cryoprobe. Methods: The study included patients with PPLs less than 30 mm in diameter scheduled to undergo bronchoscopy. All the procedures were performed using a combination of virtual bronchoscopic navigation, radial endobronchial ultrasound (R-EBUS) and X-ray fluoroscopy, and all the samples were collected using the cryoprobe alone. Thereafter, we assessed the diagnostic outcomes and safety profiles.Results: A total of 50 patients were enrolled and underwent cryobiopsy. The median lesion size was 20.8 mm (range, 8.2–29.6 mm), and the negative bronchus sign was seen in 34% of lesions. The diagnostic yield was 94% (95% confidence interval, 83.5–98.8%). A positive bronchus sign had a significantly higher diagnostic yield than did a negative bronchus sign (100% vs. 82.4%; P=0.035). The yield was achieved regardless of other variables, including lesion size, location, and R-EBUS findings. The major complications were mild and moderate bleeding in 28% and 62% of patients, respectively. Pneumothorax was identified in one patient.Conclusion: Transbronchial cryobiopsy using the new 1.7-mm cryoprobe is a feasible procedure that has the potential to increase the diagnostic accuracy for PPLs.Trial Registration: Japan Registry of Clinical Trials, jRCT1032200065. Registered 8 July 8 2020, https://jrct.niph.go.jp/en-latest-detail/jRCT1032200065

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 Continuous Dynamic Registration of Microvascularization of Liver Tumors with Contrast-Enhanced Ultrasound

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Lukas Philipp Beyer ◽  
Benedikt Pregler ◽  
Isabel Wiesinger ◽  
Christian Stroszczynski ◽  
Philipp Wiggermann ◽  
...  
Keyword(s):  
Liver Tumors ◽  
Malignant Tumors ◽  
Regional Blood Flow ◽  
Late Phase ◽  
Diagnostic Value ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Time To Peak ◽  
Contrast Enhanced ◽  
Significant Difference

Aim.To evaluate the diagnostic value of quantification of liver tumor microvascularization using contrast-enhanced ultrasound (CEUS) measured continuously from the arterial phase to the late phase (3 minutes).Material and Methods.We present a retrospective analysis of 20 patients with malignant (n=13) or benign (n=7) liver tumors. The tumors had histopathologically been proven or clearly identified using contrast-enhanced reference imaging with either 1.5 T MRI (liver specific contrast medium) or triphase CT and follow-up. CEUS was performed using a multifrequency transducer (1–5 MHz) and a bolus injection of 2.4 mL sulphur hexafluoride microbubbles. A retrospective perfusion analysis was performed to determine TTP (time-to-peak), RBV (regional blood volume), RBF (regional blood flow), and Peak.Results.Statistics revealed a significant difference (P<0.05) between benign and malignant tumors in the RBV, RBF, and Peak but not in TTP (P=0.07). Receiver operating curves (ROC) were generated for RBV, RBF, Peak, and TTP with estimated ROC areas of 0.97, 0.96, 0.98, and 0.76, respectively.Conclusion.RBV, RBF, and Peak continuously measured over a determined time period of 3 minutes could be of valuable support in differentiating malignant from benign liver tumors.

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.

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 Contrast-Enhanced Ultrasound in the Bladder: Critical Features to Differentiate Occupied Lesions

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Qiping Liu ◽  
Huiling Gong ◽  
Hui Zhu ◽  
Chunyan Yuan ◽  
Bin Hu
Keyword(s):  
Blood Flow ◽  
Malignant Tumors ◽  
Color Doppler ◽  
Diagnostic Value ◽  
Flow Imaging ◽  
Contrast Enhanced Ultrasound ◽  
Color Doppler Flow Imaging ◽  
Clinical Value ◽  
Contrast Enhanced ◽  
Significant Difference

Objective. To study the clinical diagnostic value of contrast-enhanced ultrasound (CEUS) in bladder occupied lesions. Methods. 38 cases of conventional-ultrasound-found bladder occupied lesions did color Doppler flow imaging (CDFI) and CEUS checks. By comparing the difference between two types of blood flow imaging technologies in displaying the flow of bladder occupied lesions and observing the perfusion modes of contrast agents to enter lesions, the perfusion characteristics of CEUS were analyzed. Finally, they were contrasted with the surgical pathology results. Results. Of all the 38 cases, there were 51 bladder occupied lesions, including 43 bladder malignant tumors, 2 bladder inverted papillomas, and 6 glandular cystitis lesions. The blood flow display rate of bladder occupied lesions was 100% using CEUS. Apparently, it was higher than that of CDFI (62.7%), and the result of these showed a statistically significant difference ( P < 0.05 ). Using CEUS, 46 malignant lesions and 5 glandular cystitis lesions were indicated, and the diagnostic accuracy rate was 86.3%. Conclusion. CEUS can improve the blood flow display rate of bladder occupied lesions, and it can also observe the real-time blood flow of these lesions. It can help judge their nature and has a higher clinical value in differentiating the benign from the malignant.

scholarly journals Video-Assisted Thoracoscopic Surgery in Patients With Clinically Resectable Lung Tumors

1996 ◽  
Vol 2 (3) ◽  
pp. 151-155
Author(s):  
H. Sakai ◽  
P. J. Borgstein ◽  
M. A. Cuesta ◽  
S. Meijer ◽  
J. C. van Mourik ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Malignant Tumors ◽  
Lung Metastases ◽  
Thoracoscopic Surgery ◽  
Lung Tumors ◽  
Benign Tumors ◽  
Metastatic Tumors ◽  
Thoracoscopic Resection ◽  
Lung Cancers ◽  
Video Assisted

To investigate the feasibility of thoracoscopic resection, a pilot study was performed in patients with clinically resectable lung tumors. In 40 patients, Video-assisted thoracic surgery (VATS) was performed because of suspicion of malignancy. There were 29 men and 11 women with a median age of 54.8 years (range 18 to 78). Preoperative indications were suspected lung cancer and tumor in 27 patients, assessment of tumor resectability in 7 patients, and probability of metastatic tumors in 6 patients. The final diagnoses in the 27 patients with suspected lung cancer were 12 primary lung cancers, 6 lung metastases, and 9 benign lesions. The success rates for VATS (no conversion to thoracotomy) were 1 of 12 (8.3%) for resectable stage I lung cancer, 8 of 12 (66.7%) for metastatic tumors, and 9 of 9 (100%) for benign tumors. With VATS, 6 of 7 patients (85.7%), possible stage III non-small cell lung cancer, an explorative thoracotomy with was avoided, significantly reducing morbidity. The reasons for conversion to thoracotomy were 1) oncological (N2 lymph node dissection and prevention of tumor spillage) and 2) technical (inability to locate the nodule, central localization, no anatomical fissure, or poor lung function requiring full lung ventilation). The ultimate diagnoses were 19 lung cancers, 12 metastatic lung tumors, and 9 benign lung tumors. Our data show the limitations of VATS for malignant tumors in general use. These findings, together with the fact that experience in performing thoracoscopic procedures demonstrates a learning curve, may limit the use of thoracoscopic resection as a routine surgical procedure, especially when strict oncological rules are respected.

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