The Diagnostic Accuracy and Sensitivity for Malignancy of Radial-Endobronchial Ultrasound and Electromagnetic Navigation Bronchoscopy for Sampling of Peripheral Pulmonary Lesions: Systematic Review and Meta-analysis

The objective of this study was to determine the comparative diagnostic accuracy, sensitivity, and negative predictive value for R-EBUS and ENB in sampling PPLs. Methods: A systematic review and meta-analysis were conducted. The Ovid Medline database was queried for original research reporting a diagnostic yield of R-EBUS or ENB for PPLs identified on computed tomography chest suspicious for malignancy. The I2 statistic assessed study heterogeneity. Random effects models produced pooled estimates of diagnostic accuracy and sensitivity for malignancy. Reasons for heterogeneity were explored with meta-regression. Publication bias and small study effects were assessed. Results: A total of 41 studies involved 2988 lung nodules (R-EBUS 2102, ENB 886) in 3204 patients (R-EBUS 2097, ENB 1107). Overall sensitivity to detect cancer was 70.7% [95% confidence interval (CI): 67.2-74.0]; R-EBUS 70.5% (95% CI: 66.1-74.8), ENB 70.7% (95% CI: 64.7-76.8). Pooled overall diagnostic accuracy was 74.2% (95% CI: 71.0-77.3); R-EBUS 72.4% (95% CI: 68.7-76.1), ENB 76.4% (95% CI: 70.8-82.0). The localization modalities had comparative safety profiles of
Source: Journal of Bronchology and Interventional Pulmonology - Category: Respiratory Medicine Tags: Original Investigations Source Type: research

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ger U Abstract Flexible bronchoscopy and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) are the pulmonologists´ basic procedures for the biopsy of suspicious lung lesions. If inconclusive, other guiding-modalities for tissue sampling are needed, computed tomography performed by a radiologist, or - if available - radial EBUS or electromagnetic navigation biopsy. We wanted to investigate if same-day X-ray fluoroscopy-guided transthoracic fine-needle aspiration biopsy (F-TTNAB) performed by the pulmonologist immediately after bronchoscopy and EBUS is a feasible alternative. We retr...
Source: Clinical Lung Cancer - Category: Cancer & Oncology Authors: Tags: Eur Clin Respir J Source Type: research
We present the case of an asymptomatic woman, a chronic heavy smoker, who presented with an incidental lung mass and mediastinal lymphadenopathy. Bronchoscopy with transbronchial biopsy and endobronchial ultrasound-guided transbronchial needle aspiration did not show malignancy. A positron emission tomography/computed tomography scan showed increased uptake with a standardized uptake value of 26.4 in the mediastinal lymph node and an additional hypermetabolic right supraclavicular lymph node. Surgical biopsy of the supraclavicular node revealed non-necrotizing granuloma. Discussion of the clinical dilemma is provided. ...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Respir Med Case Rep Source Type: research
Conclusion: We conclude that it is feasible for pulmonologist to perform FLB immediately after endoscopy as a combined triple approach in a fast-track workup of suspected lung cancer.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung cancer Source Type: research
Conclusions: The most common cause of ML were malignant diseases. Sarcoidosis and HF accounted for the majority of benign ML causes, while infections only occasionally were diagnosed as the cause of ML.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pleural and mediastinal malignancies Source Type: research
Conclusion Diagnostic procedures should be chosen based on the clinical character in EBUS-TBNA negative patients with suspected lung cancer. Long time follow-up is very important in patients whose diagnosis is apparently unknown. 
 DOI: 10.3779/j.issn.1009-3419.2019.04.04
Source: Chinese Journal of Lung Cancer - Category: Cancer & Oncology Source Type: research
Guidelines recommend endosonography for mediastinal nodal staging in patients with resectable nonsmall cell lung cancer (NSCLC). We hypothesise that a systematic endobronchial ultrasound (EBUS) evaluation combined with an oesophageal investigation using the same EBUS bronchoscope (EUS-B) improves mediastinal nodal staging versus the current practice of targeted positron emission tomography (PET)-computed tomography (CT)-guided EBUS staging alone. A prospective, multicentre, international study (NCT02014324) was conducted in consecutive patients with (suspected) resectable NSCLC. After PET-CT, patients underwent systematic ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung cancer Original Articles: Lung cancer Source Type: research
Conclusions: GGO cases can be possibly diagnosed by EBUS-GS depending on the findings of blizzard sign. In addition, adenocarcinoma in-situ or minimally invasive carcinoma that presents as GGO on CT scan often exhibits weak cellular atypia, which can be interpreted as class 3 on cytology. In such cases, evaluation of EGFR mutation might contribute the diagnosis.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
The optimal approach to follow patients up after surgical resection of non-small cell lung cancer (NSCLC) is keenly debated; including what imaging modality to use and the intensity of clinical assessments. A systematic review in 2012 concluded that “the paucity of evidence precludes firm evidence based guidelines” [1]. This uncertainty leads to a variability of practice nationally and internationally, which ranges from routine physical examination plus chest X-ray (CXR) [2] to more intensive protocols including routine computed tomography (CT) of the thorax, bronchoscopy, abdominal ultrasound, CT brain and bon...
Source: Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
A lesion in a 73‐year‐old woman that was suspected to be right lung cancer was biopsied under ultrasound‐guided bronchoscopy with a guide sheath. The procedure was completed without a noticeable problem, but after 3 days, it was found that the tip of the ultrasonic probe sheath was broken and that the broken fragment was missing. Based on the concern that the fragment had been left in the lung, the patient was examined by computed tomography scan 4 days after the biopsy, and bronchoscopy was repeated 38 days after the biopsy, but no fragment was detected. These procedures and an investigation by the Olympus Co...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research
Abstract Lung nodules are being increasingly detected, particularly with lung cancer screening with low-dose computed tomography. Although the vast majority of lung nodules are benign, many often require tissue diagnosis. Several modalities to obtain diagnostic tissue from peripheral lung nodules are available. Bronchoscopic modalities such as radial ultrasound and electromagnetic navigational bronchoscopy are becoming increasingly used because of their superior safety profile and improving diagnostic yield. Although these modalities continue to become more advanced, newer and complementary technologies appear pro...
Source: Clinical Lung Cancer - Category: Cancer & Oncology Authors: Tags: Clin Chest Med Source Type: research
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