EBUS Guidance for Peripheral Biopsies

Chapter

Abstract

Peripheral pulmonary lesions represent an increasing problem for today’s pulmonary medicine. With an increasing number of incidentally detected small peripheral nodules in screening CT scans, a decreasing size of these nodules due to better radiological resolution and a high number of co-morbidities making surgical interventions difficult, it is important to improve bronchoscopic navigation to these lesions.

Radial endobronchial ultrasound offers a minimally invasive method for localisation. With the aid of endobronchial ultrasound, the overall yield of bronchoscopy for peripheral lung lesions and SPN has been significantly increased. Many studies to date have reported a diagnostic sensitivity of over 70 %, and the safety and efficacy of this method has been shown.

Keywords

Catheter Pneumothorax 

Suggested Reading

  1. 1.
    Gould MK, Fletcher J, Iannettoni MD, et al. Evaluation of patients with pulmonary nodules: when is it lung cancer? ACCP evidence-based clinical practice guidelines (2nd ed). Chest. 2007;132:108S–30.PubMedCrossRefGoogle Scholar
  2. 2.
    Gopal M, Abdullah SE, Grady JJ, Goodwin JS. Screening for lung cancer with low-dose computed tomography: a systematic review and meta-analysis of the baseline findings of randomized controlled trials. J Thorac Oncol. 2010;5:1233–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Ohno Y, Hatabu H, Takenaka D, et al. CT-guided transthoracic needle aspiration biopsy of small (< or  =  20 mm) solitary pulmonary nodules. AJR Am J Roentgenol. 2003;180:1665–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Ost D, Fein AM, Feinsilver SH. Clinical practice. The solitary pulmonary nodule. N Engl J Med. 2003;348:2535–42.PubMedCrossRefGoogle Scholar
  5. 5.
    Schreiber G, McCrory DC. Performance characteristics of different modalities for diagnosis of suspected lung cancer: summary of published evidence. Chest. 2003;123:115S–28.PubMedCrossRefGoogle Scholar
  6. 6.
    Herth FJ, Ernst A, Becker HD. Endobronchial ultrasound-guided transbronchial lung biopsy in solitary pulmonary nodules and peripheral lesions. Eur Respir J. 2002;20:972–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Chao TY, Lie CH, Chung YH, Wang JL, Wang YH, Lin MC. Differentiating peripheral pulmonary lesions based on images of endobronchial ultrasonography. Chest. 2006;130:1191–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Kuo CH, Lin SM, Chen HC, Chou CL, Yu CT, Kuo HP. Diagnosis of peripheral lung cancer with three echoic features via endobronchial ultrasound. Chest. 2007;132:922–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Gasparini S, Ferretti M, Secchi EB, Baldelli S, Zuccatosta L, Gusella P. Integration of transbronchial and percutaneous approach in the diagnosis of peripheral pulmonary nodules or masses. Experience with 1,027 consecutive cases. Chest. 1995;108:131–7.PubMedCrossRefGoogle Scholar
  10. 10.
    Yamada N, Yamazaki K, Kurimoto N, et al. Factors related to diagnostic yield of transbronchial biopsy using endobronchial ultrasonography with a guide sheath in small peripheral pulmonary lesions. Chest. 2007;132:603–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Eberhardt R, Morgan RK, Ernst A, Beyer T, Herth FJ. Comparison of suction catheter versus forceps biopsy for sampling of solitary pulmonary nodules guided by electromagnetic navigational ­bronchoscopy. Respiration. 2010;79:54–60.PubMedCrossRefGoogle Scholar
  12. 12.
    Kurimoto N, Miyazawa T, Okimasa S, et al. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically. Chest. 2004;126:959–65.PubMedCrossRefGoogle Scholar
  13. 13.
    Herth FJ, Eberhardt R, Becker HD, Ernst A. Endobronchial ultrasound-guided transbronchial lung biopsy in fluoroscopically invisible solitary pulmonary nodules: a prospective trial. Chest. 2006;129:147–50.PubMedCrossRefGoogle Scholar
  14. 14.
    Yoshikawa M, Sukoh N, Yamazaki K, et al. Diagnostic value of endobronchial ultrasonography with a guide sheath for peripheral pulmonary lesions without x-ray fluoroscopy. Chest. 2007;131:1788–93.PubMedCrossRefGoogle Scholar
  15. 15.
    Eberhardt R, Ernst A, Herth FJ. Ultrasound-guided transbronchial biopsy of solitary pulmonary nodules less than 20 mm. Eur Respir J. 2009;34:1284–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Steinfort DP, Khor YH, Manser RL, Irving LB. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis. Eur Respir J. 2010;37(4):902–10.PubMedCrossRefGoogle Scholar
  17. 17.
    Asahina H, Yamazaki K, Onodera Y, et al. Transbronchial biopsy using endobronchial ultrasonography with a guide sheath and virtual bronchoscopic navigation. Chest. 2005;128:1761–5.PubMedCrossRefGoogle Scholar
  18. 18.
    Eberhardt R, Anantham D, Ernst A, Feller-Kopman D, Herth F. Multimodality bronchoscopic diagnosis of peripheral lung lesions: a randomized controlled trial. Am J Respir Crit Care Med. 2007;176:36–41.PubMedCrossRefGoogle Scholar
  19. 19.
    Harms W, Krempien R, Grehn C, Hensley F, Debus J, Becker HD. Electromagnetically navigated brachytherapy as a new treatment option for peripheral pulmonary tumors. Strahlenther Onkol. 2006;182:108–11.PubMedCrossRefGoogle Scholar
  20. 20.
    Tanabe T, Koizumi T, Tsushima K, et al. Comparative study of three different catheters for CT imaging-bronchoscopy-guided radiofrequency ablation as a potential and novel interventional therapy for lung cancer. Chest. 2010;137:890–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Eberhardt R, Kahn N, Herth FJ. ‘Heat and destroy’: bronchoscopic-guided therapy of peripheral lung lesions. Respiration. 2010;79:265–73.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Pneumology & Respiratory Care MedicineThoraxklinik at the University of HeidelbergHeidelbergGermany

Personalised recommendations