title: Diagnostic performance of convex probe EBUS-TBNA in patients with mediastinal and coexistent endobronchial or peripheral lesions.
abstract: To compare the performance of convex probe endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) with conventional endobronchial biopsy (EBB) or transbronchial lung biopsy (TBLB) in patients with mediastinal, and coexisting endobronchial or peripheral lesions.Retrospective review of records of patients undergoing diagnostic EBUS-TBNA and conventional bronchoscopy in 2014.A total of 74 patients had mediastinal, and coexisting endobronchial or peripheral lesions. The detection rate of EBUS-TBNA for mediastinal lesion >1 cm in short axis, EBB for visible exophytic type of endobronchial lesion, and TBLB for peripheral lesion with bronchus sign were 71%, 75%, and 86%, respectively. In contrast, the detection rate of EBUS-TBNA for mediastinal lesion ≤1 cm in short axis, EBB for mucosal hyperemia type of endobronchial lesion, and TBLB for peripheral lesion without bronchus sign were 25%, 63%, and 38%, and improved to 63%, 88%, and 62% respectively by adding EBB or TBLB to EBUS-TBNA, and EBUS-TBNA to EBB or TBLB. Postprocedure bleeding was significantly more common in patients undergoing EBB and TBLB 8 (40%) versus convex probe EBUS-TBNA 2 patients (2.7%, P = 0.0004).EBUS-TBNA is a safer single diagnostic technique compared with EBB or TBLB in patients with mediastinal lesion of >1 cm in size, and coexisting exophytic type of endobronchial lesion, or peripheral lesion with bronchus sign. However, it requires combining with EBB or TBLB and vice versa to optimize yield when mediastinal lesion is ≤1 cm in size, and coexisting endobronchial and peripheral lesions lack exophytic nature, and bronchus sign, respectively.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore.
authors.forename: Akash
authors.initials: A
authors.lastname: Verma
authors.forename: Kee San
authors.initials: KS
authors.lastname: Goh
authors.forename: Chee Kiang
authors.initials: CK
authors.lastname: Phua
authors.forename: Wen Yuan
authors.initials: WY
authors.lastname: Sim
authors.forename: Kuan Sen
authors.initials: KS
authors.lastname: Tee
authors.forename: Albert Y H
authors.initials: AYH
authors.lastname: Lim
authors.forename: Dessmon Y H
authors.initials: DYH
authors.lastname: Tai
authors.forename: Soon Keng
authors.initials: SK
authors.lastname: Goh
authors.forename: Ai Ching
authors.initials: AC
authors.lastname: Kor
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ho
authors.forename: Sennen J W
authors.initials: SJW
authors.lastname: Lew
authors.forename: John
authors.initials: J
authors.lastname: Abisheganaden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001980:Bronchi / Q000473:pathology; D001999:Bronchoscopy; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008297:Male; D008482:Mediastinum / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity