Role of endobronchial ultrasound-guided transbronchial needle aspiration in the management of lung cancer

• Published in: General thoracic and cardiovascular surgery Vol. 56; no. 6; pp. 268 - 276
• Main Authors: Yasufuku, Kazuhiro, Nakajima, Takahiro, Fujiwara, Taiki, Chiyo, Masako, Iyoda, Akira, Yoshida, Shigetoshi, Suzuki, Makoto, Sekine, Yasuo, Shibuya, Kiyoshi, Yoshino, Ichiro
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.06.2008; Springer Nature B.V
• Subjects: Biopsy, Fine-Needle; Bronchoscopes; Bronchoscopy - methods; Cardiac Surgery; Cardiology; Current Topics Review Article; Endosonography; Equipment Design; Humans; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic system; Medicine; Medicine & Public Health; Neoplasm Staging; Predictive Value of Tests; Surgical Oncology; Thoracic Surgery; Tumors; Ultrasonic imaging; Bronchoscopy; Lymph node metastasis; Endobronchial ultrasound; Staging; Lung cancer
• ISSN: 1863-6705; 1863-6713
• DOI: 10.1007/s11748-008-0249-4

Endobronchial ultrasound (EBUS) is a promising new modality first introduced during the early 1990s. The radial probe EBUS was initially developed seeking for high-resolution imaging of processes in the airway wall and outside the airways. The structure of special importance was lymph nodes, walls of the central airways, and the mediastinum. After the development of miniaturized radial probes with flexible catheters having a balloon at the tip, it has been applied to aid bronchoscopists during biopsy of patients with respiratory diseases. In particular, the role of EBUS in transbronchial needle aspiration (TBNA) has been established. Radial probe EBUS-guided TBNA has increased the yield of TBNA of mediastinal lymph nodes, although it was still not a real-time procedure with target visualization. New convex probe EBUS (CP-EBUS) with the ability to perform real-time EBUS-guided TBNA (EBUS-TBNA) has emerged to overcome these problems. Indications for EBUS-TBNA are (1) lymph node staging in lung cancer patients; (2) diagnosis of intrapulmonary tumors; (3) diagnosis of unknown hilar and/or mediastinal lymphadenopathy; and (4) diagnosis of mediastinal tumors. Case series using EBUS-TBNA for mediastinal lymph node staging in lung cancer have reported a high yield, ranging from 89% to 98% (average 94.5%). To date, there are no reports of major complications related to EBUS-TBNA. EBUS-TBNA is a novel approach with a high diagnostic yield that is safe. The aim of this article was to review the current role of EBUS-TBNA for the management of lung cancer patients.