scholarly journals Diagnostic Performance of Electromagnetic Navigation Bronchoscopy-Guided Biopsy for Lung Nodules in the Era of Molecular Testing

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1432
Author(s):  
Ju Hyun Oh ◽  
Chang-Min Choi ◽  
Seulgi Kim ◽  
Se Jin Jang ◽  
Sang Young Oh ◽  
...  
Keyword(s):  
Safety Profile ◽  
Diagnostic Yield ◽  
Growth Factor Receptor ◽  
Pulmonary Nodules ◽  
Molecular Testing ◽  
Nsclc Tissue ◽  
Transthoracic Needle Biopsy ◽  
Electromagnetic Navigation ◽  
Anaplastic Lymphoma ◽  
Guided Biopsy

Electromagnetic navigation bronchoscopy (ENB) is an emerging technique used to evaluate peripheral lung lesions. The aim of this study was to determine the diagnostic yield, safety profile, and adequacy of specimens obtained using ENB for molecular testing. This single-center, prospective pilot study recruited patients with peripheral pulmonary nodules that were not suitable for biopsy via percutaneous transthoracic needle biopsy methods. The possibility of molecular testing, including epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), and programmed death ligand 1 (PD-L1), was identified with non-small cell lung cancer (NSCLC) tissue obtained using ENB. ENB-guided biopsy was performed on 30 pulmonary nodules in 30 patients. ENB-guided biopsy was successfully performed in 96.6% (29/30) of cases, but one case failed to approach the target lesion. The diagnostic accuracy of ENB-guided biopsy was 68.0% (17/25). Biopsy-related pneumothorax occurred in one patient and there was no major bleeding or deaths related to the procedure. Among 13 patients diagnosed with NSCLC, molecular testing was successfully performed in 92.3% (12/13). ENB-guided biopsy demonstrated acceptable accuracy and excellent sample adequacy, with a high possibility of achieving molecular testing and a good safety profile to evaluate peripheral pulmonary nodules, even when the percutaneous approach was difficult and/or dangerous.

Role of Ultrasound-Guided Tru-cut Biopsy in the Diagnosis of Peripheral Lung and Pleural Lesions

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Mohamed Wagih ◽  
Nehad Mohammed Osman ◽  
walid Heta ◽  
Fatma El-Zahraa Abdellatif
Keyword(s):  
Diagnostic Yield ◽  
Tube Placement ◽  
Consecutive Series ◽  
University Hospitals ◽  
Transthoracic Needle Biopsy ◽  
Lung Lesions ◽  
Pulmonary Lesions ◽  
Guided Biopsy ◽  
High Flow Oxygen ◽  
Peripheral Lung

Abstract Background Transthoracic needle biopsy is a well-established technique for diagnosing pulmonary lesions. Computed tomography (CT) is usually used as guidance. Ultrasound (US)-guided biopsy is a relatively affordable modality for diagnosis of peripheral lung lesions (PLLs; also known as peripheral pulmonary lesions [PPLs]) and peripheral pleural lesions. Objectives The purpose of this study was to study the diagnostic yield of US guidance sampling a consecutive series of peripheral lung and pleural lesions and potential factors influencing the diagnostic yield with recording the occurrence of any complications. Patients and Methods This was a prospective study that was conducted at Ain Shams University Hospitals upon a population of 60 patients, during the period from September 2018 to August 2019. A special puncture transducer is used to perform US-guided biopsy with visualization of the biopsy needle and the lesion; facilitating the sampling procedure. Results The use of US-guided transthoracic needle biopsies across 60 patients was shown to have a yield of 75% which found the occurrence of 45 conclusive and 15 non-conclusive results From this study population, 70% (n = 42/45) were found to have malignant manifestations, of which 26 were undifferentiated high grade adenocarcinoma, and 9 were moderately differentiated adenocarcinoma. As for complications arising from the biopsy procedure, twenty percent 20% (n = 12) of patients suffered from complications in the form of hemoptysis in 8 which was controlled by hemostatic measures and 4 patients acquired pneumothorax, three (¾) of them received high flow oxygen and conservative treatment and only one (1/4) patient had intercostal tube placement. Diagnostic yield was significantly increased with the presence of Wedge shaped hypoechoic lesions(p < 0.001), hard Mass consistency was significantly highly associated with conclusive results (p < 0.001), as well as a significant link between the longitudinal diameter of masses that had a mean length of 45.05mm ±12.93mm (#x0003D; 0.029).It also showed that more biopsies taken were highly significant correlation with conclusive outcomes (p < 0.001). Conclusion US-guided biopsy is a robust and accurate procedure to effectively diagnose peripheral lung lesions, with a low incidence of complications and gradually improving results with the mastery of the procedure.

scholarly journals The Diagnostic Yield of Navigational Bronchoscopy Performed with Propofol Deep Sedation

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Uma Mohanasundaram ◽  
Lawrence A. Ho ◽  
Ware G. Kuschner ◽  
Rajinder K. Chitkara ◽  
James Canfield ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Deep Sedation ◽  
Diagnostic Yield ◽  
Pulmonary Nodules ◽  
Lesion Size ◽  
Adenocarcinoma In Situ ◽  
Electromagnetic Navigation ◽  
Positron Emission ◽  
Inflammatory Processes ◽  
Radiographic Followup

Objective. To describe the diagnostic yield of electromagnetic navigation bronchoscopy (ENB) utilizing propofol for procedural deep sedation. Methods. We conducted a structured retrospective analysis of the medical records of patients who underwent ENB with propofol for the evaluation of pulmonary nodules and masses. We analyzed the relationships between lesion size and location, variance (CT-to-body divergence), and positron emission tomography findings on diagnostic yield. Diagnoses were established by histopathological evaluation and clinical-radiographic followup. Results. 41 patients underwent ENB during the study period. The overall diagnostic yield was 89% (42 of 47 target lesions). Among the 42 positive specimens, the diagnoses were squamous cell carcinoma (n=10), adenocarcinoma (n=14), small cell carcinoma (n=2), adenocarcinoma in situ (n=2), coccidioidomycosis (n=1), and inflammatory processes (n=13). Average lesion size was 3.01±0.21 cm and variance 3.6±0.15 mm. The diagnostic yield was greater when the lesion size was >4 cm (100%) and when variance was ≤4 mm (91% versus 87%, P=0.003). Conclusion. The diagnostic yield of ENB utilizing propofol for procedural deep sedation at our center was excellent. ENB with deep sedation may result in superior diagnostic yield compared with ENB performed with moderate sedation.

Reflex Testing for Epidermal Growth Factor Receptor Mutation and Anaplastic Lymphoma Kinase Fluorescence In Situ Hybridization in Non–Small Cell Lung Cancer

2011 ◽  
Vol 135 (5) ◽  
pp. 655-664
Author(s):  
Mari Mino-Kenudson ◽  
Eugene J. Mark
Keyword(s):  
Lung Cancer ◽  
Kinase Inhibitors ◽  
Egfr Mutation ◽  
Growth Factor Receptor ◽  
Small Cell ◽  
Molecular Testing ◽  
Small Cell Lung ◽  
Alk Rearrangement ◽  
Anaplastic Lymphoma ◽  
Epidermal Growth

Abstract Context.—Non–small cell lung cancer (NSCLC) is a poor-prognosis malignancy for which more effective treatments are needed, with accumulating clinical experiences supporting benefits of receptor tyrosine kinase inhibitors for patients with tumors harboring an epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) rearrangement. Objective.—To review completed and ongoing clinical trials of EGFR tyrosine kinase inhibitors for EGFR mutation–positive NSCLC and an ALK inhibitor for those with ALK rearrangement, while also exploring practical issues surrounding the implementation of molecular testing as a routine component of the diagnostic workup of NSCLC in the United States. Data Sources.—Published biomedical literature, abstracts presented at recent major oncology meetings, and ClinicalTrials.gov. Conclusions.—Continually evolving evidence indicates the possible efficacy of molecularly targeted agents for the treatment of advanced NSCLC, especially adenocarcinoma. To identify patients who will most likely benefit from the targeted therapy, routine determination of the corresponding genetic alterations after histologic diagnosis of NSCLC (reflex molecular testing for EGFR mutations and ALK rearrangement) should be considered.

Respiratory Cytology—Current Trends Including Endobronchial Ultrasound-Guided Biopsy and Electromagnetic Navigational Bronchoscopy: Analysis of Data From a 2013 Supplemental Survey of Participants in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology

2016 ◽  
Vol 140 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Charles D. Sturgis ◽  
Carrie B. Marshall ◽  
Guliz A. Barkan ◽  
Christine N. Booth ◽  
Daniel F. I. Kurtycz ◽  
...  
Keyword(s):  
Growth Factor Receptor ◽  
Endobronchial Ultrasound ◽  
Molecular Testing ◽  
Ultrasound Guided ◽  
Screening Programs ◽  
Anaplastic Lymphoma ◽  
Current Trends ◽  
Epidermal Growth ◽  
Electromagnetic Navigational Bronchoscopy ◽  
Cytology Screening

Context Nongynecologic cytology (NGC) practices are expanding in relationship to historical gynecologic cytology screening programs. Bronchopulmonary cytology is experiencing an evolution regarding new procedural types. The College of American Pathologists (CAP) tracks practice patterns in NGC by developing questionnaires, surveying participants, and analyzing respondent data. Objective To analyze responses to a 2013 CAP supplemental survey from the Interlaboratoy Comparison Program on bronchopulmonary NGC. Design The “NGC 2013 Supplemental Questionnaire: Demographics in Performance and Reporting of Respiratory Cytology” was mailed to 2074 laboratories. Results The survey response rate was 42% (880 of 2074) with 90% of respondents (788 of 880) indicating that their laboratories evaluated cytology bronchopulmonary specimens. More than 95% of respondents indicated interpreting bronchial washings (765 of 787) and bronchial brushings (757 of 787). A minority of laboratories (43%, 340 of 787) dealt with endobronchial ultrasound-guided samples, and an even smaller fraction of laboratories (14%, 110 of 787) saw cases from electromagnetic navigational bronchoscopy. Intraprocedural adequacy assessments by pathologists (and less often by cytotechnologists or pathologists-in-training) were routinely performed in percutaneous transthoracic aspiration cases (74%, 413 of 560) with less involvement for other case types. Most laboratories reported that newly diagnosed primary pulmonary adenocarcinomas were triaged for molecular testing of epidermal growth factor receptor and anaplastic lymphoma kinase. Conclusions The parameters examined in this 2013 survey provide a snapshot of current pulmonary cytopathology practice and may be used as benchmarks in the future.

scholarly journals Tumour tissue sampling for lung cancer management in the era of personalised therapy: what is good enough for molecular testing?

2014 ◽  
Vol 44 (4) ◽  
pp. 1011-1022 ◽  
Author(s):  
Lucia Kim ◽  
Ming Sound Tsao
Keyword(s):  
Lung Cancer ◽  
Kinase Inhibitors ◽  
Tumour Progression ◽  
Growth Factor Receptor ◽  
Nonsmall Cell Lung Cancer ◽  
Tumour Tissue ◽  
Molecular Testing ◽  
Anaplastic Lymphoma ◽  
Cancer Management ◽  
Nsclc Patients

In the era of personalised cancer therapy, the demand for molecular profiling of the patient’s tumour is steadily increasing. In advanced nonsmall cell lung cancer (NSCLC) patients, testing for epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) gene rearrangements has become an essential component of clinical practice to select patients who are most likely to benefit from EGFR and ALK tyrosine kinase inhibitors, respectively. Furthermore, obtaining tissue specimens from recurrent or metastatic tumours or from patients who develop resistance to initial effective therapies are essential for our understanding of the molecular basis of tumour progression and development of drug resistance. Therefore, the sampling of tumour tissue that is representative and is adequate in quantity and quality for pathological diagnosis and genomic profiling is crucial. In this review, we will discuss factors that should be considered in obtaining and processing biopsy specimens to enable routine molecular analysis in NSCLC patients.

scholarly journals Diagnostic yield and safety of biopsy guided by electromagnetic navigation bronchoscopy for high‐risk pulmonary nodules

2021 ◽  
Author(s):  
Ju Hyun Oh ◽  
Chang‐Min Choi ◽  
Seulgi Kim ◽  
Woo Sung Kim ◽  
Hee Sang Hwang ◽  
...  
Keyword(s):  
High Risk ◽  
Diagnostic Yield ◽  
Pulmonary Nodules ◽  
Electromagnetic Navigation

scholarly journals Molecular Testing for Selection of Patients With Lung Cancer for Epidermal Growth Factor Receptor and Anaplastic Lymphoma Kinase Tyrosine Kinase Inhibitors: American Society of Clinical Oncology Endorsement of the College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology Guideline

2014 ◽  
Vol 32 (32) ◽  
pp. 3673-3679 ◽  
Author(s):  
Natasha B. Leighl ◽  
Natasha Rekhtman ◽  
William A. Biermann ◽  
James Huang ◽  
Mari Mino-Kenudson ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Kinase Inhibitors ◽  
International Association ◽  
Growth Factor Receptor ◽  
Molecular Testing ◽  
Review Panel ◽  
Anaplastic Lymphoma ◽  
Epidermal Growth ◽  
American Society ◽  
Selection Of

Purpose The College of American Pathologists (CAP), the International Association for the Study of Lung Cancer (IASLC), and the Association for Molecular Pathology (AMP) guideline on molecular testing for the selection of patients with lung cancer for epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors was considered for endorsement. Methods American Society of Clinical Oncology (ASCO) staff reviewed the CAP/IASLC/AMP guideline for developmental rigor; an ASCO ad hoc review panel of experts reviewed the guideline content. Results The ASCO panel concurred that the recommendations are clear, thorough, and based on the most relevant scientific evidence in this content area and present options that will be acceptable to patients. The CAP/IASLC/AMP guideline comprises 37 recommendations (evidence grade A or B), expert consensus opinions, or suggestions that address the following five principal questions: (1) When should molecular testing be performed? (2) How should EGFR testing be performed? (3) How should ALK testing be performed? (4) Should other genes be routinely tested in lung adenocarcinoma? (5) How should molecular testing be implemented and operationalized? Conclusion The ASCO review panel endorses the CAP/IASLC/AMP guideline. This guideline represents an important advance toward standardization of EGFR and ALK testing practices and is of major clinical relevance in advancing the care of patients with lung cancer. In the Discussion section, the ASCO review panel highlights three evolving areas: advances in ALK testing methodology, considerations for selecting appropriate populations for molecular testing, and emergence of other targetable molecular alterations.

scholarly journals Diagnostic Yield of Combined Pulmonary Cryobiopsies and Electromagnetic Navigation in Small Pulmonary Nodules

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Olivier Taton ◽  
Benjamin Bondue ◽  
Pierre Alain Gevenois ◽  
Myriam Remmelink ◽  
Dimitri Leduc
Keyword(s):  
Diagnostic Yield ◽  
Pulmonary Nodules ◽  
Electromagnetic Navigation ◽  
Pet Ct ◽  
Endobronchial Ultrasonography ◽  
Risk Patients ◽  
Peripheral Pulmonary Lesions ◽  
Transbronchial Lung Cryobiopsy ◽  
Fdg Pet Ct ◽  
Small Pulmonary Nodules

Background. An increasing number of pulmonary nodules of unknown nature are detected as a result of screening by CT in high lung cancer risk patients. Objectives. The purposes of this study were to assess the diagnostic yield of electromagnetic navigation bronchoscopy (ENB) combined with transbronchial lung cryobiopsy (TBLC) and to compare it with standard transbronchial biopsy (TBB) in pulmonary nodules of less than 2 cm in diameter. Methods. We prospectively included 32 patients (18 men and 14 women, mean age 68 ± 9 years) with nodules of less than 2 cm in diameter and no metastasis at 18FDG PET-CT. The nodule position was determined by ENB, radial endobronchial ultrasonography miniprobe, and fluoroscopy. Eight samples were obtained, six by TBB and two by TBLC. Results. Nodule diameter averaged 16 ± 3 mm. Twenty-five nodules were malignant and 18 were surgically resected. Surgery was avoided in four patients as the biopsies revealed a benign disease. The samples obtained by TBLC were five times larger than those by TBB. The diagnostic yields of TBLC and TBB were 69% and 38%, respectively (p=0.017). Adverse events consisted in 15 mild or moderate bleedings and one pneumothorax. Conclusions. In the setting of peripheral pulmonary lesions of less than 20 mm in diameter, ENB-combined TBLC is feasible and safe, provides larger samples, and has higher diagnostic yield than TBB.

Sign in / Sign up

Export Citation Format

Share Document