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Radial Endobronchial ultrasound

Su-Juan Zhang, Ming Zhang, Jun Zhou, Qiu-Di Zhang, Qian-Qian Xu, Xiong Xu
Background: Peripheral pulmonary lesions (PPLs) are being discovered more frequently. We investigated efficiency, safety, and influencing factors in radial probe endobronchial ultrasound with distance measurement (rEBUS-D) using a thin bronchoscope during transbronchial biopsy (TBB) for the diagnosis of malignant PPLs. Methods: Patients with PPLs who underwent rEBUS were retrospectively analyzed. Cases with rEBUS-D and a gold-standard final diagnosis were considered...
February 2018: Translational Lung Cancer Research
Daizo Yaguchi, Motoshi Ichikawa, Noriko Inoue, Daisuke Kobayashi, Masato Shizu, Naoyuki Imai
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...
May 2018: Respirology Case Reports
Gonzalo Labarca, Iván Caviedes, Erik Folch, Adnan Majid, Sebastián Fernández-Bussy
In the last years, several techniques have been developed to obtain a prompt diagnosis or rule out lung cancer. Endobronchial ultrasound- guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure with a high diagnostic yield for mediastinal and central pulmonary lesions. This procedure is especially useful for lung cancer diagnosis and mediastinal staging. Two different types of EBUS are currently available: Radial EBUS and lineal EBUS. Each one has technical differences together with a range of clinical indications...
September 2017: Revista Médica de Chile
Samy Lachkar, Jean-Marc Baste, Luc Thiberville, Christophe Peillon, Philippe Rinieri, Nicolas Piton, Florian Guisier, Mathieu Salaun
BACKGROUND: Minimally invasive surgery of pulmonary nodules allows suboptimal palpation of the lung compared to open thoracotomy. OBJECTIVE: The objective of this study was to assess endoscopic pleural dye marking using radial endobronchial ultrasound (r-EBUS) and virtual bronchoscopy to localize small peripheral lung nodules immediately before minimally invasive resection. METHODS: The endoscopic procedure was performed without fluoroscopy, under general anesthesia in the operating room immediately before minimally invasive surgery...
January 25, 2018: Respiration; International Review of Thoracic Diseases
Yeji Han, Hyun Jung Kim, Kyoung Ae Kong, Soo Jung Kim, Su Hwan Lee, Yon Ju Ryu, Jin Hwa Lee, Yookyoung Kim, Sung Shine Shim, Jung Hyun Chang
BACKGROUND: Advances in bronchoscopy and CT-guided lung biopsy have improved the evaluation of small pulmonary lesions (PLs), leading to an increase in preoperative histological diagnosis. We aimed to evaluate the efficacy and safety of transbronchial lung biopsy using radial endobronchial ultrasound and virtual bronchoscopic navigation (TBLB-rEBUS&VBN) and CT-guided transthoracic needle biopsy (CT-TNB) for tissue diagnosis of small PLs. METHODS: A systematic search was performed in five electronic databases, including MEDLINE, EMBASE, Cochrane Library Central Register of Controlled Trials, Web of Science, and Scopus, for relevant studies in May 2016; the selected articles were assessed using meta-analysis...
2018: PloS One
Samantha Herath, Elaine Yap
In diagnosing peripheral pulmonary lesions (PPL), radial endobronchial ultrasound (R-EBUS) is emerging as a safer method in comparison to CT-guided biopsy. Despite the better safety profile, the yield of R-EBUS remains lower (73%) than CT-guided biopsy (90%) due to the smaller size of samples. We adopted a hybrid method by adding cryobiopsy via the R-EBUS Guide Sheath (GS) to produce larger, non-crushed samples to improve diagnostic capability and enhance molecular testing. We report six prospective patients who underwent this procedure in our institution...
February 2018: Respirology Case Reports
Ayush Gupta, Jagdish Chander Suri, Dipak Bhattacharya, Manas Kamal Sen, Shibdas Chakrabarti, Abhijeet Singh, Tulsi Adhikari
BACKGROUND: Peripheral pulmonary lesions (PPLs) pose a diagnostic challenge, and the optimal investigation in many such cases remains unclear. Computed tomography (CT)-guided percutaneous needle biopsy (CT-PNB) has been the modality of choice for such lesions with a high diagnostic accuracy but with high rates of pneumothorax. Endobronchial ultrasound (EBUS) with a radial probe is an alternate diagnostic modality with increased diagnostic yield of bronchoscopy in the evaluation of PPL...
January 2018: Lung India: Official Organ of Indian Chest Society
Haitao Huang, Shaomu Chen, Liangbin Pan, Ke Chen, Feirong Yao, Haitao Ma
BACKGROUND: With the application of high resolution computed tomography (CT), a large number of peripheral lung lesions were found. It put forward new challenge on clinical diagnosis and treatment for these peripheral lung lesions. Electromagnetic navigation bronchoscopy (ENB) and radial endobronchial ultrasound probe (R-EBUS) are new technologies used for the diagnosis of peripheral lung lesions. The aim of this study is to explore the application value of ENB combined with R-EBUS in the diagnosis of peripheral pulmonary lesions...
December 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Huang Haidong, Ning Yunye, Zhang Wei, Paul Zarogoulidis, Wolfgang Hohenforst-Schmidt, Yan-Gao Man, Yang Yuguang, Dong Yuchao, Bai Chong
Objective To evaluate the value of multiple guided technologies based on radial probe endobronchial ultrasound (R-EBUS) in the application of the diagnosis of solitary pulmonary peripheral lesions (PPLs). Methods Analysis of diagnostic yield in 4 groups patients with different combined multiple guided technologies based on R-EBUS, 94 patients with 94 solitary PPLs from Mar, 2013 to Nov, 2014 in Changhai Hospital. Results The overall diagnostic yield was 75% (70/94), the diagnostic yield of Group A (R-EBUS) was 62%(16/26), Group B (R-EBUS with guided sheath, EBUS-GS) was 76% (34/45), Group C (EBUS-GS with fluoroscopy) was 82% (9/11), Group D (virtual bronchoscopic navigation guided EBUS-GS with fluoroscopy) was 92% (11/12)...
2017: Journal of Cancer
K Darwiche, F Özkan, C Wolters, S Eisenmann
Endobronchial Ultrasound (EBUS) with the two modalities curved and radial EBUS significantly improved the diagnostics in several pulmonary diseases. The examination and staging of mediastinal and hilar lymph nodes in patients with known or suspected lung malignancy as well as the evaluation of unknown pulmonary or mediastinal lesions can be achieved with minimal invasive means when using EBUS. More invasive surgical procedures for diagnostic purposes can be omitted. The diagnostic yield also increases when EBUS is applied in sarcoidosis or mediastinal lymph node tuberculosis but only to some extend in case of lymphoma...
November 2017: Pneumologie
Chun-Ta Huang, Yi-Ju Tsai, Chao-Chi Ho, Chong-Jen Yu
BACKGROUND: Radial-probe endobronchial ultrasound (rEBUS)-guided transbronchial biopsy (TBB) is invaluable in the diagnosis of peripheral pulmonary lesions (PPLs); however, in certain instances, the procedure has to be repeated because of initial non-diagnostic procedure(s). Little if any literature has been published on this issue. Therefore, the aim of this study was to investigate the utility of repeat rEBUS-guided TBB in achieving a definitive diagnosis of PPLs. METHODS: All patients who underwent rEBUS-guided TBB of PPLs at National Taiwan University Hospital between 2011 and 2015 and had a repeat procedure after non-diagnostic initial procedures were identified as the study subjects...
October 17, 2017: BMC Pulmonary Medicine
Qiudi Zhang, Sujuan Zhang, Xiong Xu, Qianqian Xu, Jun Zhou
Computer tomography-guided transthoracic needle aspiration (CT-TTNA) is a minimally invasive technique for sampling peripheral lung lesions. Radial endobronchial ultrasound-guided transbronchial biopsy (rEBUS-TBB) is an alternative. The present study analyzed and compared rEBUS-TBB and CT-TTNA in the diagnosis of peripheral pulmonary lesions (PPL).Clinical data of 513 patients with PPL who underwent an rEBUS-TBB or CT-TTNA examination were analyzed retrospectively. The positive diagnostic rate, complication rate, and influencing factors of the 2 methods were compared...
August 2017: Medicine (Baltimore)
Andrew D Lerner, David Feller-Kopman
With the greater use of chest CT, the incidental detection of lung nodules is expected to increase. However, because most lung nodules are benign, there is a high demand for minimally invasive procedures that provide valuable diagnostic information while minimizing complications. Recent advances in bronchoscopic technology meet this demand. These advanced technologies include navigational bronchoscopy and radial endobronchial ultrasound (EBUS) for the diagnosis of peripheral lung nodules, and linear EBUS, which has revolutionized the nonoperative nodal staging of lung cancer and provides a complementary option to surgical staging approaches...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
Adam R Belanger, Jason A Akulian
Lung cancer remains a common and deadly disease. Many modalities are available to the bronchoscopist to evaluate and stage lung cancer. We review the role of bronchoscopy in the staging of the mediastinum with convex endobronchial ultrasound (EBUS) and discuss emerging role of esophageal ultrasonography as a complementary modality. In addition, we discuss advances in scope technology and elastography. We review the bronchoscopic methods available for the diagnosis of peripheral lung nodules including radial EBUS and navigational bronchoscopy (NB) with a consideration of the basic methodologies and diagnostic accuracies...
May 2017: Therapeutic Advances in Respiratory Disease
Sandeep J Khandhar, Mark R Bowling, Javier Flandes, Thomas R Gildea, Kristin L Hood, William S Krimsky, Douglas J Minnich, Septimiu D Murgu, Michael Pritchett, Eric M Toloza, Momen M Wahidi, Jennifer J Wolvers, Erik E Folch
BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) is an image-guided, minimally invasive approach that uses a flexible catheter to access pulmonary lesions. METHODS: NAVIGATE is a prospective, multicenter study of the superDimension™ navigation system. A prespecified 1-month interim analysis of the first 1,000 primary cohort subjects enrolled at 29 sites in the United States and Europe is described. Enrollment and 24-month follow-up are ongoing. RESULTS: ENB index procedures were conducted for lung lesion biopsy (n = 964), fiducial marker placement (n = 210), pleural dye marking (n = 17), and/or lymph node biopsy (n = 334; primarily endobronchial ultrasound-guided)...
April 11, 2017: BMC Pulmonary Medicine
Kuo-Yang Huang, Pin-Zuo Ko, Chih-Wei Yao, Cheng-Nan Hsu, Hsin-Yuan Fang, Chih-Yeh Tu, Hung-Jen Chen
BACKGROUND: The prognostic significance of the new classification of lung adenocarcinoma proposed in the 2015 World Health Organization guideline has been validated. This study aimed to compare the preoperative classification of the adenocarcinoma subtype based on computed tomography-guided 18-gauge core needle biopsy (CTNB) or radial probe endobronchial ultrasound (R-EBUS) specimens, with the postoperative classification based on the resected specimens. METHODS: We retrospectively analyzed a consecutive series of 128 patients (60 CTNB and 68 R-EBUS) who underwent surgery for preoperatively confirmed lung adenocarcinoma between 2010 and 2014...
July 2017: Journal of Thoracic and Cardiovascular Surgery
Ping Zhan, Qing-Qing Zhu, Ying-Ying Miu, Ya-Fang Liu, Xiao-Xia Wang, Ze-Jun Zhou, Jia-Jia Jin, Qian Li, Shinji Sasada, Takehiro Izumo, Chih-Yen Tu, Wen-Chien Cheng, Matthew Evison, Tang-Feng Lv, Yong Song
BACKGROUND: With the release of the National Lung Screening Trial results, the detection of peripheral pulmonary lesions (PPLs) is likely to increase. Computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and radial probe endobronchial ultrasound (r-EBUS)-guided transbronchial lung biopsy (TBLB) are recommended for tissue diagnosis of PPLs. METHODS: A systematic review of published literature evaluating the accuracy of r-EBUS-TBLB and CT-PTNB for the diagnosis of PPLs was performed to determine point sensitivity and specificity, and to construct a summary receiver-operating characteristic curve...
February 2017: Translational Lung Cancer Research
Ilya G Berim, Ali I Saeed, Ahmed Awab, Adam Highley, Agnes Colanta, Fawad Chaudry
Fluoroscopy-guided transbronchial forceps biopsy has a low diagnostic yield in patients with radiographic suspicion of interstitial lung disease. Cryobiopsy has a higher diagnostic yield likely due to preserved lung architecture and larger biopsies; however, there is an increased risk of major airway bleeding and pneumothorax. Simultaneous use of endobronchial balloon blocker allows for containment of bleeding after cryobiopsy to the affected lobe. In the current article we describe use of radial ultrasound in identification of a target lung parenchyma without a major blood vessel adjacent to distal bronchi...
April 2017: Journal of Bronchology & Interventional Pulmonology
Semra Bilaçeroğlu
PURPOSE OF REVIEW: As demonstrated by the recent therapeutic advances in nonsmall cell lung cancer (NSCLC), a personalized approach can considerably reduce its mortality. RECENT FINDINGS: Molecular tests identifying genetic mutations in NSCLC have led to a shift towards more effective and personalized therapies targeted to these alterations. Adequate tissue is required for diagnosing, subcharacterizing, and genotyping NSCLC by morphological, immunohistochemical, and molecular techniques...
May 2017: Current Opinion in Pulmonary Medicine
Muhammad S Ali, William Trick, Benjamin I Mba, Divyanshu Mohananey, Jaskaran Sethi, Ali I Musani
Tissue diagnosis of peripheral pulmonary lesions (PPLs) can be challenging. In the past, flexible bronchoscopy was commonly performed for this purpose but its diagnostic yield is suboptimal. This has led to the development of new bronchoscopic modalities such as radial endobronchial ultrasound (R-EBUS), electromagnetic navigation bronchoscopy (ENB) and virtual bronchoscopy (VB). We performed this meta-analysis using data from previously published R-EBUS studies, to determine its diagnostic yield and other performance characteristics...
April 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
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