title: Electromagnetic navigation-guided TBNA vs conventional TBNA in the diagnosis of mediastinal lymphadenopathy.
abstract: OBJECTIVE
  Conventional transbronchial needle aspiration (C-TBNA) is a safe method for the diagnosis of hilar and mediastinal lymphadenopathy (MLN). However, diagnostic yield of this technique varies considerably. Electromagnetic navigation bronchoscopy (ENB) is a new technology to increase the diagnostic yield of flexible bronchoscopy for the peripheral lung lesions and MLN. The aim of this prospective study was to compare the diagnostic and sampling success of ENB-guided TBNA (ENB-TBNA) in comparison with C-TBNA while dealing with MLN.
  
  
  METHODS
  Consecutive patients with MLN were randomized into two groups - C-TBNA and ENB-TBNA - using a computer-based number shuffling system to avoid recruitment bias. Procedures were performed in usual fashion, published previously.
  
  
  RESULTS
  Ninety-four cases (M/F: 45/49) with a total of 145 stations of MLN were enrolled in the study. In 44 patients, 81 stations were sampled by ENB-TBNA, and in 50 patients 64 stations by C-TBNA. The mean size of MLN in study subjects was 17.56 ± 6.25 mm. The sampling success was significantly higher in ENB-TBNA group (82.7%) compared with C-TBNA group (51.6%) (P < 0.005). Defined by histopathological result, the diagnostic yield in ENB-TBNA was 72.8%, and 42.2% with C-TBNA (P < 0.005). For subcarinal localization, sampling or diagnostic success was higher in ENB-TBNA than that of C-TBNA (P < 0.05). Based on the size of the MLN ≤15 mm or >15 mm, the sampling success of ENB-TBNA was also significantly higher than C-TBNA in both subgroups (P < 0.005 and P < 0.005, respectively). No serious complication was observed.
  
  
  CONCLUSIONS
  In this study comparing ENB-TBNA and C-TBNA, the sampling and diagnostic success of ENB-TBNA was found to be superior while dealing with MLN, in all categories studied.
authors: Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey.
authors: Özlem E
authors: ÖE
authors: Diken
authors: Demet
authors: D
authors: Karnak
authors: Aydın
authors: A
authors: Çiledağ
authors: Koray
authors: K
authors: Ceyhan
authors: Çetin
authors: Ç
authors: Atasoy
authors: Serdar
authors: S
authors: Akyar
authors: Oya
authors: O
authors: Kayacan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000379:methods*; D055590:Electromagnetic Phenomena; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008175:Lung Neoplasms / Q000473:pathology*; D008206:Lymphatic Diseases / Q000473:pathology*; D008297:Male; D008477:Mediastinal Diseases / Q000473:pathology*; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: bronchoscopy; electromagnetic navigation; electromagnetic navigation bronchoscopy; flexible bronchoscopy; mediastinal lymph node; transbronchial needle aspiration