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EUS-B-FNA Enhances the Diagnostic Yield of EBUS Bronchoscope for Intrathoracic Lesions

  • INTERVENTIONAL PULMONOLOGY
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Abstract

Introduction

Endobronchial ultrasound (EBUS) bronchoscopes have been used mainly through the airway for EBUS-guided transbronchial needle aspiration (EBUS-TBNA); however, they can also be used through the esophagus. The esophageal approach, endoscopic ultrasound with bronchoscope-guided fine needle aspiration (EUS-B-FNA), has gradually become popular, as it can evaluate lesions that cannot be accessed through the airway.

Purpose

This study aimed to evaluate the value of adding EUS-B-FNA to EBUS-TBNA performed by pulmonologists for intrathoracic lesions in the clinical setting.

Methods

Between March 2009 and March 2020, all patients who underwent EUS-B-FNA and EBUS-TBNA for diagnostic purposes were included and retrospectively analyzed at a single institution.

Results

A total of 1794 procedures using an EBUS bronchoscope including, EBUS-TBNA, EUS-B-FNA, and the combination of EBUS-TBNA and EUS-B-FNA for evaluating intrathoracic lesions, were performed. We finally analyzed 276 patients who underwent EUS-B-FNA for diagnostic purposes. EUS-B-FNA provided diagnostic materials from only EBUS-TBNA-inaccessible lesions in 26 patients and in 18 patients whose conditions were inappropriate for bronchoscopy (e.g., respiratory failure, airway stenosis, etc.). EUS-B-FNA provided diagnostic results in four patients with non-diagnostic EBUS-TBNA results. EUS-B-FNA was preferable to EBUS-TBNA in 4.4% (48 of 1091) of patients; therefore, adding EUS-B-FNA to EBUS-TBNA increased the diagnostic yield from 72.6% (1043 of 1437) to 75.9% (1091 of 1437).

Conclusion

Pulmonologists are able to enhance diagnostic yields by acquiring the EUS-B-FNA technique.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

There was no funding for this study.

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Authors and Affiliations

  1. Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, 460-0001, Japan

    Atsushi Torii, Masahide Oki, Arisa Yamada, Yoshihito Kogure, Chiyoe Kitagawa & Hideo Saka

Authors
  1. Atsushi Torii
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  2. Masahide Oki
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  3. Arisa Yamada
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  4. Yoshihito Kogure
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  5. Chiyoe Kitagawa
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  6. Hideo Saka
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Contributions

AT and MO contributed to study design, data collection, analysis, and interpretation. All authors contributed to perform the EUS-B-FNA and EBUS-TBNA. The first draft of the manuscript was written by AT and MO and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Atsushi Torii.

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Competing interest

The authors have no conflicts of interest to declare.

Ethical Approval

This study was approved by the institutional review board of National Hospital Organization Nagoya Medical Center (ID: 2021–060).

Informed Consent

Informed consent for the procedures was obtained from all patients, but informed consent for this study was waived as it was a retrospective study.

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Torii, A., Oki, M., Yamada, A. et al. EUS-B-FNA Enhances the Diagnostic Yield of EBUS Bronchoscope for Intrathoracic Lesions. Lung 200, 643–648 (2022). https://doi.org/10.1007/s00408-022-00563-w

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  • DOI: https://doi.org/10.1007/s00408-022-00563-w

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