Journal articles: 'Radial EBUS'

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Jacomelli, Marcia, Sergio Eduardo Demarzo, Paulo Francisco Guerreiro Cardoso, Addy Lidvina Mejia Palomino, and Viviane Rossi Figueiredo. "Radial-probe EBUS for the diagnosis of peripheral pulmonary lesions." Jornal Brasileiro de Pneumologia 42, no. 4 (August 2016): 248–53. http://dx.doi.org/10.1590/s1806-37562015000000079.

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ABSTRACT Objective: Conventional bronchoscopy has a low diagnostic yield for peripheral pulmonary lesions. Radial-probe EBUS employs a rotating ultrasound transducer at the end of a probe that is passed through the working channel of the bronchoscope. Radial-probe EBUS facilitates the localization of peripheral pulmonary nodules, thus increasing the diagnostic yield. The objective of this study was to present our initial experience using radial-probe EBUS in the diagnosis of peripheral pulmonary lesions at a tertiary hospital. Methods: We conducted a retrospective analysis of 54 patients who underwent radial-probe EBUS-guided bronchoscopy for the investigation of pulmonary nodules or masses between February of 2012 and September of 2013. Radial-probe EBUS was performed with a flexible 20-MHz probe, which was passed through the working channel of the bronchoscope and advanced through the bronchus to the target lesion. For localization of the lesion and for collection procedures (bronchial brushing, transbronchial needle aspiration, and transbronchial biopsy), we used fluoroscopy. Results: Radial-probe EBUS identified 39 nodules (mean diameter, 1.9 ± 0.7 cm) and 19 masses (mean diameter, 4.1 ± 0.9 cm). The overall sensitivity of the method was 66.7% (79.5% and 25.0%, respectively, for lesions that were visible and not visible by radial-probe EBUS). Among the lesions that were visible by radial-probe EBUS, the sensitivity was 91.7% for masses and 74.1% for nodules. The complications were pneumothorax (in 3.7%) and bronchial bleeding, which was controlled bronchoscopically (in 9.3%). Conclusions: Radial-probe EBUS shows a good safety profile, a low complication rate, and high sensitivity for the diagnosis of peripheral pulmonary lesions.

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Zo, Sungmin, Sook-young Woo, Seonwoo Kim, Jung Eun Lee, Byeong-Ho Jeong, Sang-Won Um, Hojoong Kim, O. Jung Kwon, Ho Yun Lee, and Kyungjong Lee. "Predicting the Risk of Malignancy of Lung Nodules Diagnosed as Indeterminate on Radial Endobronchial Ultrasound-Guided Biopsy." Journal of Clinical Medicine 9, no. 11 (November 13, 2020): 3652. http://dx.doi.org/10.3390/jcm9113652.

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The next diagnostic step in cases of indeterminate radial probe endobronchial ultrasound (radial EBUS)-guided biopsy results remains uncertain. This study aimed to identify risk factors for malignancy based on clinical findings, chest computed tomography (CT), and radial EBUS images, and to estimate the risk of malignancy in lung nodules that showed indeterminate radial EBUS-guided biopsy results by constructing a nomogram. This retrospective study included 157 patients with indeterminate results on an initial radial EBUS biopsy performed at the Samsung Medical Center from January 2017 to December 2018, but with a definitive final diagnosis. Medical records, chest CT, radial EBUS images, and the final diagnoses were reviewed. Patients were randomly divided into training and validation sets. Factors related to malignancy were identified through logistic regression analysis, and a nomogram was constructed using the training set and subsequently applied to the validation set. Six factors in univariable and multivariable analyses, including upper lobe location, spiculation, satellite nodules, echogenicity, presence of dots or linear arcs, and patency of vessels and bronchi predicted malignancy. A nomogram was constructed based on these predictors. The area under the curve (AUC) value of the nomogram was 0.858 using the chest CT factors, which improved to 0.952 when radial EBUS factors were added. The calibration curve showed good agreement between the actual and nomogram-predicted malignancy outcomes. The utility of radial EBUS images for revealing risk factors of malignancy was confirmed. Furthermore, our nomogram was able to predict the probability of malignancy in lung nodules with indeterminate radial EBUS-guided biopsy results.

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Izumo, Takehiro, Shinji Sasada, Christine Chavez, Yuji Matsumoto, and Takaaki Tsuchida. "Radial endobronchial ultrasound images for ground-glass opacity pulmonary lesions." European Respiratory Journal 45, no. 6 (January 8, 2015): 1661–68. http://dx.doi.org/10.1183/09031936.00167914.

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Radial endobronchial ultrasound (R-EBUS) is a useful tool for precise localisation of peripheral pulmonary lesions, but there have been no detailed reports about the use of R-EBUS images for ground-glass opacity (GGO).The R-EBUS images of 116 patients with GGO, who were diagnosed as having adenocarcinoma by R-EBUS with a guide sheath (EBUS-GS), were compared with the respective chest computed tomography findings. In 103 patients, R-EBUS images were correlated with the histological surgical specimens.R-EBUS images of GGO were identified based on the internal structure of the lesion and classified into two groups. Blizzard showed an enlarged, diffuse hyperintense acoustic shadow. Mixed blizzard showed a combination of blizzard and some diffuse heterogeneity with several hyperechoic dots and vessels. All pure GGO lesions (nine out of nine) were blizzard on R-EBUS. For part-solid GGOs, the percentage of mixed blizzard was inversely related to the amount of the GGO component. Histological findings from surgery revealed that all blizzard lesions were on the spectrum of adenocarcinoma in situ to well differentiated adenocarcinoma while majority (33 out of 64) of mixed blizzard lesions were moderately to poorly differentiated adenocarcinoma.R-EBUS types are important to locate GGOs prior to transbronchial sampling with EBUS-GS.

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Chen, Alexander. "Lung Nodules and Radial EBUS." Journal of Bronchology & Interventional Pulmonology 19, no. 1 (January 2012): 3–4. http://dx.doi.org/10.1097/lbr.0b013e3182442d6a.

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Lachkar, Samy, Mathieu Salaün, Loic Perrot, Diane Gervereau, Marielle De Marchi, Gurvan Le Bouar, Helene Morisse-Pradier, et al. "Virtual Bronchoscopy Planner and Radial-EBUS Guided Biopsy for Organizing Pneumonia Diagnosis." Journal of Clinical Medicine 11, no. 1 (December 25, 2021): 104. http://dx.doi.org/10.3390/jcm11010104.

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Background: The diagnosis of organizing pneumonia (OP) often requires histological confirmation. The aim of this retrospective study was to evaluate the diagnostic yield and complication rate of radial endobronchial ultrasound (r-EBUS) for OP. Methods: All patients who had r-EBUS as a first diagnostic procedure for a peripheral pulmonary lesion at Rouen University Hospital, France, between April 2008 and December 2020 were included. Cases without a final diagnosis of OP or follow-up were excluded. Patients, lesions, and r-EBUS characteristics were retrospectively analyzed. Results: 2735 r-EBUS procedures were performed, and 33 cases with final OP could be analyzed. Procedures were performed under local anesthesia in 28/33 cases (85%). Among the 33 final OP cases, 17 were considered cryptogenic, and 16 secondary. The lesions were patchy alveolar opacities in 23 cases (70%), masses or pulmonary nodules in 8 cases (24%), and diffuse infiltrative opacities in 2 cases (6%). A bronchus sign on CT scan was found in all cases. In 22 cases (67%), a histopathological diagnosis was obtained from the r-EBUS samples. In 4 cases (12%), histopathological diagnosis was made by surgery, and in 7 cases (21%) the diagnosis was made based on clinical, radiological, and evolution features. An ultrasound image was found in 100% (22/22) of cases in the r-EBUS positive (r-EBUS+) group vs. 60% (6/10) in the r-EBUS negative (r-EBUS-) group, respectively (p < 0.002). The diagnostic yield of r-EBUS for OP was 67% and increased to 79% (22/28) when an ultrasound image was obtained. The median time between CT scan and r-EBUS procedure was 14 days (3–94): 11.5 days in the r-EBUS+ group and 22 days in the r-EBUS- group (p < 0.0001). No severe complications were reported. Conclusion: r-EBUS, when performed shortly after a CT scan showing a bronchus sign, is an efficient and safe technique for OP diagnosis.

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Jiang, Ling, Jian Xu, Chunfang Liu, Na Gao, Jing Zhao, Xue Han, Xiaolin Zhang, et al. "Diagnosis of Peripheral Pulmonary Lesions with Transbronchial Lung Cryobiopsy by Guide Sheath and Radial Endobronchial Ultrasonography: A Prospective Control Study." Canadian Respiratory Journal 2021 (September 28, 2021): 1–8. http://dx.doi.org/10.1155/2021/6947037.

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Objective. We design a prospective control study on the utilization of transbronchial cryobiopsy guided by EBUS-GS (EBUS-GS-TBCB) to diagnose PPLs. Methods. PPLs were defined as pulmonary nodules or masses with a diameter from 10 mm to 50 mm. PPLs were randomly divided into group EBUS-GS-TBCB and transbronchial biopsy by forceps guided under EBUS-GS (EBUS-GS-TBB). Results. 28 cases were involved in group EBUS-GS-TBCB and 31 cases were in group EBUS-GS-TBB. The mean sizes of PPLs were 30.23 ± 11.10 mm in group EBUS-GS-TBCB and 28.69 ± 8.62 mm in group EBUS-GS-TBB (t = 0.600, p = 0.551 ). The diagnostic yields of EBUS-GS-TBCB and EBUS-GS-TBB were 75% and 64.52% respectively, and the difference between the two groups was not significant (χ2 value = 0.137, p = 0.711 ). If only the first specimen was taken into account, the diagnostic yields from EBUS-GS-TBCB and EBUS-GS-TBB were 64.29% (18/28 cases) and 35.48% (11/31 cases), respectively. The difference was statistically significant by Fisher’s Exact Test (χ2 value = 4.883, p = 0.038 ). The total incidence rates of bleeding were 21.43% and 6.45%, respectively, in groups EBUS-GS-TBCB and EBUS-GS-TBB. The total incidence rates of pneumothorax were 7.14% and 0, respectively, in groups EBUS-GS-TBCB and EBUS-GS-TBB. Conclusion. The diagnostic yield of EBUS-GS-TBCB was slightly higher than that of EBUS-GS-TBB for the diagnosis of PPLs. EBUS-GS-TBCB might be useful if only the first sample was taken into account.

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Chung, Hyun Sung, Soohyun Bae, Insu Kim, Hyo Yeong Ahn, and Jung Seop Eom. "Unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe endobronchial ultrasound." PLOS ONE 16, no. 1 (January 28, 2021): e0246371. http://dx.doi.org/10.1371/journal.pone.0246371.

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Background Bronchoscopy using radial probe endobronchial ultrasound (EBUS) is performed when a peripheral lung lesion (PLL) is suspected to be malignant. However, pulmonary tuberculosis is diagnosed in some patients, and healthcare workers could therefore be exposed to tuberculosis if sufficient precautions are not taken. In this study, we examined the proportion of and factors associated with unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe EBUS. Methods This retrospective study included 970 patients who received bronchoscopy using radial probe EBUS between December 2015 and November 2018. Clinical, histological, radiological, and microbiological data were reviewed. Results Pulmonary tuberculosis was diagnosed in 31 patients (3.2%) during bronchoscopy using radial probe EBUS. Patients with a lower age were significantly more likely to be diagnosed with tuberculosis than elderly patients (odds ratio [OR], 0.951; 95% confidence interval [CI], 0.924–0.978; P = 0.001). Among the various CT findings, a low HUs difference between pre- and post-enhanced CT (OR, 0.976; 95% CI, 0.955–0.996; P = 0.022), the presence of concentric cavitation (OR, 5.211; 95% CI, 1.447–18.759; P = 0.012), and the presence of satellite centrilobular nodules (OR, 22.925; 95% CI, 10.556–49.785; P < 0.001) were independently associated with diagnosis of tuberculosis. Conclusions The proportion of unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe EBUS was 3.2%. A higher risk was independently associated with a younger age and CT findings of a small difference in HUs between pre- and post-enhancement images, concentric cavitation, and the presence of a satellite centrilobular nodule.

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Inomata, Minoru, Naoyuki Kuse, Nobuyasu Awano, Mari Tone, Hanako Yoshimura, Tatsunori Jo, Jonsu Minami, et al. "Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study." BMJ Open Respiratory Research 8, no. 1 (January 2021): e000826. http://dx.doi.org/10.1136/bmjresp-2020-000826.

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BackgroundRadial endobronchial ultrasonography (R-EBUS) has been used in conjunction with transbronchial lung cryobiopsy (TBLC) to diagnose diffuse parenchymal lung disease (DPLD) and to decrease the risk of bleeding complications. The diagnostic utility of different R-EBUS signs, however, remains unknown.ObjectivesThis study aimed to determine whether different R-EBUS signs could be used to more accurately diagnose DPLD and whether bronchial bleeding could be prevented with use of R-EBUS during TBLC.MethodEighty-seven patients with DPLD were included in this multicentre prospective study, with 49 patients undergoing R-EBUS. R-EBUS signals were characterised as displaying either dense or blizzard signs. Pathological confidence of specimens obtained from TBLC was compared between patients with dense versus blizzard signs, and severity of bronchial bleeding was determined based on whether R-EBUS was performed or not.ResultsAll patients with dense signs on R-EBUS showed consolidation on high-resolution CT (HRCT) imaging. Pathological confidence of lung specimens was significantly higher in patients with dense signs versus those with blizzard signs (p<0.01) and versus those who did not undergo R-EBUS (p<0.05). Patients who underwent TBLC with R-EBUS were more likely to experience no or mild bronchial bleeding than patients who did not undergo R-EBUS (p<0.01), with shorter procedure times (p<0.01).ConclusionsThe dense R-EBUS sign corresponded with consolidation on HRCT. High-quality lung specimens may be obtainable when the dense sign is observed on R-EBUS, and R-EBUS combined with TBLC may reduce risk of bronchial bleeding and shorten procedure times.

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Yu, Kai-Lun, Shun-Mao Yang, Huan-Jang Ko, Hui-Yu Tsai, Jen-Chung Ko, Ching-Kai Lin, Chao-Chi Ho, and Jin-Yuan Shih. "Efficacy and Safety of Cone-Beam Computed Tomography-Derived Augmented Fluoroscopy Combined with Endobronchial Ultrasound in Peripheral Pulmonary Lesions." Respiration 100, no. 6 (2021): 538–46. http://dx.doi.org/10.1159/000515181.

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Background: The diagnostic yield of peripheral pulmonary lesions (PPLs) using radial endobronchial ultrasound (EBUS) remains challenging without navigation systems. Cone-beam computed tomography-derived augmented fluoroscopy (CBCT-AF) represents a recently developed technique, and its clinical utility remains to be investigated. Objectives: The aim of this study was to investigate the diagnostic yield of transbronchial biopsy (TBB) using a combination of CBCT-AF and radial EBUS. Methods: We recruited consecutive patients with PPLs who underwent radial EBUS-guided TBB, with or without AF, between October 2018 and July 2019. Following propensity score 1:1 matching, we recorded the procedure-related data and measured their efficacy and safety. Results: While 72 patients received EBUS-plus-AF, 235 patients received EBUS only. We included 53 paired patients following propensity score matching. The median size of lesions was 2.8 and 2.9 cm in the EBUS-plus-AF group and EBUS-only group, respectively. Diagnostic yield was higher in the former group (75.5 vs. 52.8%; p = 0.015). The diagnostic yield for the EBUS-plus-AF group was significantly higher for lesions ≤30 mm (73.5 vs. 36.1%; p = 0.002). Moreover, there was no significant difference in the complication rates (3.8 vs. 5.7%; p = 1.000). Twenty-four nodules (45.3%) were invisible by fluoroscopy in the EBUS-plus-AF group. All of them were identifiable on CBCT images and successfully annotated for AF. The mean radiation dose of total procedure, CBCT, and fluoroscopy was 19.59, 16.4, and 3.17 Gy cm2, respectively. Conclusions: TBB using a combination of CBCT-AF and EBUS resulted in a satisfactory diagnostic yield and safety.

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Muthu, Valliappan, Inderpaul S. Sehgal, Sahajal Dhooria, Kuruswamy T. Prasad, and Ritesh Agarwal. "Reversed Halo Sign on Radial EBUS Imaging." Journal of Bronchology & Interventional Pulmonology 25, no. 4 (October 2018): e46-e48. http://dx.doi.org/10.1097/lbr.0000000000000475.

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Lim, Valencia, Reon Yew Zhou Chin, Adrian Kee, Jeffrey Ng, and Kay Choong See. "Diagnostic Yield and Safety of CP-EBUS-TBNA and RP-EBUS-TBLB under Moderate Sedation: A Single-Center Retrospective Audit." Diagnostics 12, no. 11 (October 24, 2022): 2576. http://dx.doi.org/10.3390/diagnostics12112576.

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Convex probe endobronchial ultrasound transbronchial needle aspirations (CP-EBUS-TBNAs) and radial probe endobronchial ultrasound transbronchial lung biopsies (RP-EBUS-TBLBs) can be performed under moderate sedation or general anesthesia. Moderate sedation is more convenient, however patient discomfort may result in inadequate tissue sampling. General anesthesia ensures better patient cooperation but requires more logistics and also carries sedation risks. We aim to describe the diagnostic yield and safety of CP-EBUS-TBNAs and RP-EBUS-TBLBs when performed under moderate sedation at our center. All patients who underwent CP-EBUS-TBNA and/or RP-EBUS-TBLB under moderate sedation, between January 2015 and May 2017, were reviewed. Primary outcomes were defined in regard to the diagnostic yield and safety profile. A total of 336 CP-EBUS-TBNAs and 190 RP-EBUS-TBLBs were performed between January 2015 and May 2017. The mean sedation doses used were 50 mcg of intravenous fentanyl and 2.5 mg of intravenous midazolam. The diagnostic yield of the CP-EBUS-TBNAs and RP-EBUS-TBLBs were 62.5% and 71.6%, respectively. Complication rates were low with: transient bleeding 11.9%, transient hypoxia 0.5%, and pneumothorax 0.1%. None required escalation of care, post procedure. Performing CP-EBUS-TBNAs and RP-EBUS-TBLBs under moderate sedation is safe and provides good diagnostic yield. These procedures should, therefore, be considered as first-line sampling techniques.

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Burks, A. C. "Big things come in small packages—Clinical use of endobronchial ultrasound." Journal of the Acoustical Society of America 151, no. 4 (April 2022): A111. http://dx.doi.org/10.1121/10.0010815.

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Endobronchial ultrasound (EBUS) revolutionized bronchoscopy. It first became available for clinical use in 1999 as a mechanical radial probe and was initially used to define airway wall anatomy, but was supplanted by convex probe EBUS bronchoscopes in 2002–now the preferred initial approach for evaluation of mediastinal pathology. Radial EBUS has since proven invaluable for evaluating the peripheral lung and aiding biopsy guidance despite the limitations in ultrasound (US) propagation through air filled structures. Centrally, airways pass through the mediastinum in direct contact with the esophagus, heart, great vessels, and lymph nodes, making the mediastinum amenable to direct US imaging. However, beyond the lung hila, the airways are largely surrounded by air, generally preventing production of usable US images by halting penetration and reverberation of sound waves. The tissue mass that makes up the terminal airway walls, however, does propagate ultrasound waves before encountering reflective air. The ratio of tissue to air varies according to anatomic location and physiologic/disease state; identifying patterns in the varying ratio of tissue to air within the lungs allows the ability to distinguish normal from abnormal lung. This presentation will describe the clinical use of EBUS in modern bronchoscopy.

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Kho, Sze Shyang, Swee Kim Chan, Mei Ching Yong, and Siew Teck Tie. "Performance of transbronchial cryobiopsy in eccentrically and adjacently orientated radial endobronchial ultrasound lesions." ERJ Open Research 5, no. 4 (October 2019): 00135–2019. http://dx.doi.org/10.1183/23120541.00135-2019.

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BackgroundRadial endobronchial ultrasound (R-EBUS) is an effective technique in the diagnosis of peripheral pulmonary lesions (PPL). However, lesion orientation with regards to the radial probe remains an important factor for effective biopsy. “Within” orientation was associated with significantly higher diagnostic yield. Cryobiopsy is a novel technique in obtaining larger tissue samples with the frozen tip allowing biopsy in a 360° direction, thus potentially achieving more effective biopsy in eccentrically and adjacently orientated lesions. We aimed to evaluate the performance and safety of transbronchial cryobiopsy versus forceps biopsy in eccentrically and adjacently orientated R-EBUS lesions.MethodsRetrospective review of R-EBUS transbronchial biopsy for PPL over 17 months.Results114 R-EBUS scans were included for analysis during the study period. Forceps biopsy was performed in 76 (66.7%) cases and cryobiopsy in 38 (33.3%) cases. Baseline demographics and lesion characteristics did not differ between the two groups. Median (interquartile range) lesion size was 3.48 (2.63–4.51) cm. Overall, 41.2% of lesions were of eccentric orientation and 15.8% adjacent orientation; only 43% were concentric in orientation. Overall diagnostic yield was 67.5% (77 out of 114). Orientation remained an important factor affecting diagnostic yield. Transbronchial cryobiopsy significantly increased the diagnostic yield in eccentrically and adjacently orientated lesions to 75.0% (18 out of 24), compared to 48.8% (20 out of 41) obtained via forceps biopsy (p<0.05); but not in concentric lesions. Cryobiopsy was associated with more mild and moderate bleeding complications compared to the forceps biopsy group.ConclusionsTransbronchial cryobiopsy under R-EBUS guidance is a safe procedure which potentially increases diagnostic yield in eccentrically and adjacently orientated PPLs.

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Beaudoin, Stéphane, Linda M. Ofiara, Marc Bellerose, and Anne V. Gonzalez. "Dislodgement of Radial EBUS-Guide Sheath Radiopaque Cuff." Journal of Bronchology & Interventional Pulmonology 23, no. 4 (October 2016): e34-e35. http://dx.doi.org/10.1097/lbr.0000000000000303.

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Agrawal, Abhinav, and Septimiu Murgu. "Infections After Radial EBUS-Guided Transbronchial Lung Biopsy." Chest 158, no. 2 (August 2020): 458–60. http://dx.doi.org/10.1016/j.chest.2020.04.030.

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Li, Guangsheng, Jie Huang, Yuechuan Li, and Jing Feng. "The Value of Combined Radial Endobronchial Ultrasound-Guided Transbronchial Lung Biopsy and Metagenomic Next-Generation Sequencing for Peripheral Pulmonary Infectious Lesions." Canadian Respiratory Journal 2020 (April 6, 2020): 1–9. http://dx.doi.org/10.1155/2020/2367505.

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Background. Metagenomic next-generation sequencing (mNGS) is a new technology that allows for unbiased detection of pathogens. However, there are few reports on mNGS of lung biopsy tissues for pulmonary infection diagnosis. In addition, radial endobronchial ultrasound (R-EBUS) is widely used to detect peripheral pulmonary lesions (PPLs), but it is rarely used in the diagnosis of peripheral lung infection. Objective. The present study aims to evaluate the combined application of R-EBUS-guided transbronchial lung biopsy (TBLB) and mNGS for the diagnosis of peripheral pulmonary infectious lesions. Methods. From July 2018 to April 2019, 121 patients from Tianjin Medical University General Hospital diagnosed with PPLs and lung infection were enrolled in this prospective randomized study . Once the lesion was located, either TBLB or R-EBUS-guided-TBLB was performed in randomly selected patients, and mNGS was applied for pathogen detection in lung biopsy tissues. The results of mNGS were compared between the TBLB group and R-EBUS-guided TBLB group. In addition, the clinical characteristics and EBUS images from 61 patients receiving bronchoscopy for peripheral lung infectious detection were analyzed and compared with the results of mNGS. Results. The positivity rate of mNGS in R-EBUS-guided TBLB was (78.7%, 48/61) that was significantly higher than (60.0%, 36/60) in the TBLB group. Difference in the position of R-EBUS probe and image characteristics of peripheral lung infectious lesions affected the positivity rate of mNGS. Tissue collected by R-EBUS within the lesion produced higher positivity rate than samples collected adjacent to the lesion (P=0.030, odds ratio 17.742; 95% confidence interval, from 1.325 to 237.645). Anechoic areas and luminant areas of ultrasonic image characteristics were correlated with lower positivity rate of mNGS (respectively, P=0.019, odds ratio 17.878; 95% confidence interval, from 1.595 to 200.399; P=0.042, odds ratio 16.745; 95% confidence interval, from 1.106 to 253.479). Conclusions. R-EBUS-guided TBLB is a safe and effective technique in the diagnosis of peripheral lung infectious lesions. R-EBUS significantly facilitates the accurate insertion of bronchoscope into the lesions, which improves positivity rate of mNGS analysis in pathogen detection. The R-EBUS probe position within lesion produced a higher positivity rate of mNGS analysis. Nevertheless, the presence of anechoic and luminant areas on ultrasonic image was correlated with poor mNGS positivity rate.

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Wen, Ying, Meng-chan Wang, Ying Zhou, Xu-yong Lin, Gang Hou, and Yan Yin. "Immune reconstitution inflammatory syndrome associated with Pneumocystis pneumonia in a patient with AIDS." Journal of International Medical Research 48, no. 8 (August 2020): 030006052094654. http://dx.doi.org/10.1177/0300060520946544.

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Immune reconstitution inflammatory syndrome (IRIS) after starting antiretroviral treatment for human immunodeficiency virus (HIV) infection has a wide variety of causes. Delayed diagnosis and treatment of IRIS is fatal. We report a case of a 21-year-old man with HIV infection and Pneumocystis jirovecii pneumonia. The patient presented with fever and dyspnea with deterioration of pulmonary infiltrations 5 days after starting antiretroviral treatment. We reached the diagnosis of IRIS based on radial endobronchial ultrasound (EBUS)-guided lung biopsy. In conclusion, radial EBUS-guided lung biopsy via bronchoscopy is a valuable and minimally invasive technique for the rapid diagnosis of IRIS-associated Pneumocystis jirovecii pneumonia.

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Godbout, Krystelle, Simon Martel, Mathieu Simon, Noël Lampron, and Antoine Delage. "Evaluation of Pulmonary Nodules Using the Spyglass Direct Visualization System Combined With Radial Endobronchial Ultrasound: A Clinical Feasibility Study." Open Respiratory Medicine Journal 10, no. 1 (November 30, 2016): 79–85. http://dx.doi.org/10.2174/1874306401610010079.

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Background: Sampling of peripheral pulmonary nodules with radial endobronchial ultrasound (p-EBUS) increases diagnostic yield of bronchoscopy. However, diagnostic yield is influenced by numerous factors. Objective: We evaluated the use of SpyGlass, a one millimeter diameter optic fiber, to obtain images of the distal mucosa and of pulmonary lesions detected with p-EBUS to determine if visual aspect of the distal mucosa was predictive of diagnosis. Methods: We prospectively recruited subjects investigated for peripheral nodules. Bronchoscopy was performed and p-EBUS was used to locate the lesion through a guide sheath. The Spyglass fiber was introduced in the sheath to obtain images of the distal bronchial mucosa. Tissue sampling was subsequently done. Results: Fifteen patients were enrolled in the study. A final diagnosis of malignancy was confirmed in 80%. All lesions could be located using p-EBUS (100%). Diagnostic sensitivity for p-EBUS was 58.3%. Distal mucosa could be imaged with SpyGlass in 14/15 patients (93.3%). Mucosal appearance was described as abnormal in 7 out of the 15 subjects. Mean SpyGlass procedure time was 6.5 minutes. No direct complication was reported. Conclusion: Spyglass can be used in combination with p-EBUS to obtain images of the distal bronchial mucosa and peripheral pulmonary nodules. More patients will be needed to confirm whether mucosal appearance can be predictive of malignancy.

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Steinfort, Daniel P., Asha Bonney, Katharine See, and Louis B. Irving. "Sequential multimodality bronchoscopic investigation of peripheral pulmonary lesions." European Respiratory Journal 47, no. 2 (November 5, 2015): 607–14. http://dx.doi.org/10.1183/13993003.00786-2015.

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Multiple guidance modalities may be combined during bronchoscopic investigation of peripheral pulmonary lesions (PPLs). The relative contribution of each modality to diagnostic performance remains uncertain.Endobronchial ultrasound (EBUS) with virtual bronchoscopy (VB) was routinely performed, with electromagnetic navigation (EMN) utilised only where EBUS was unable to locate PPLs or where the probe was adjacent to the lesion and on-site cytologic examination was nondiagnostic.236 consecutive patients with 245 PPLs had lesion size 22.8±12.4 mm (mean±sd). PPLs were localised using EBUS+VB alone in 188 (77%) and was diagnostic in 134 of these (71.3%). EBUS localisation was predicted by PPL size (23.7±10.5versus19.7±9.8 mm, p=0.003), but not by bronchus sign, PPL–hilum distance or PPL–pleura distance. EMN in 57 patients achieved EBUS localisation in a further 17 patients (30.9%), improving overall visualisation yield to 85%. Nine of these 57 procedures achieved a definitive diagnosis (16%), improving overall diagnostic yield to 58.4%. Probe position and lesion type influenced overall diagnostic yield. Sensitivity for diagnosis of lung cancer was 70% (131/188; 95% CI 63–76%).Localisation rate and diagnostic sensitivity of radial probe EBUS+VB alone for diagnosis of PPLs is high. EBUS localisation rates and procedural yield are improved only modestly (by 8% and 4%, respectively) with addition of EMN. Sampling following EMN should include all available methods to maximise diagnostic yield.

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Song, Ju Yeun, Sun Hye Shin, Hongseok Yoo, Byeong-Ho Jeong, Sang-Won Um, Hojoong Kim, O. Jung Kwon, and Kyungjong Lee. "Efficacy of Combining Multiple Electromagnetic Navigation Bronchoscopy Modalities for Diagnosing Lung Nodules." Journal of Clinical Medicine 11, no. 24 (December 10, 2022): 7341. http://dx.doi.org/10.3390/jcm11247341.

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Electromagnetic navigation bronchoscopy (ENB) is one of the non-invasive methods used for lung nodule biopsy. We evaluated the efficacy of combining radial endobronchial ultrasound (R-EBUS)-guided transbronchial lung biopsy (TBLB) with ENB-guided TBLB or transbronchial needle aspiration (TBNA) for diagnosing lung nodules. Forty patients with a lung nodule underwent ENB-TBLB or TBNA, followed by R-EBUS-TBLB if available. The final diagnosis was benign or malignant, depending on the surgical pathology or 24-month follow-up computed tomography (CT). We compared the sensitivity, negative predictive value, and accuracy between combinations of procedures. The mean nodule size was 21.65 mm, and 60.0% of the nodules were solid. The bronchus was within the nodule in 67.5% and 65.0% of cases examined using CT and R-EBUS, respectively. The accuracies of ENB-TBLB alone, ENB-TBLB/TBNA, and R-EBUS-TBLB plus ENB-TBLB/TBNA were 74.4%, 82.5%, and 90.0%, respectively. The sensitivity levels of the aforementioned procedures were 69.8%, 78.8%, and 87.9%, respectively. Among 21 patients who underwent both ENB-TBLB and R-EBUS-TBLB, the latter revealed malignant cells in three of nine patients (33.3%) with benign ENB-TBLB results. Combined ENB-TBLB/TBNA and R-EBUS-TBLB had increased sensitivity and diagnostic accuracy for lung nodules. ENB and R-EBUS are complementary; using both modalities improves the sensitivity and accuracy of lung nodule diagnoses.

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Sapalidis, Konstantinos, Konstantinos Romanidis, Panagoula Oikonomou, Paul Zarogoulidis, Athanasios Katsaounis, Aikaterini Amaniti, Nikolaos Michalopoulos, et al. "Convex endobronchial ultrasound: same coin, two faces. Challenging biopsy and staging for non-small-cell lung cancer." Lung Cancer Management 8, no. 4 (December 1, 2019): LMT20. http://dx.doi.org/10.2217/lmt-2019-0008.

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Lung cancer is still diagnosed at a late stage due to lack of early disease symptoms. Despite the development of new diagnostic endoscopic tools, such as radial/convex endobronchial ultrasounds (EBUS) and electromagnetic navigation, most patients are still diagnosed at advanced stage disease. Most of the patients refer to their doctor only if they cough blood or their cough changes character. There are challenging cases in the diagnosis and staging of a patient, such as the one that we will present. We present a case of lung cancer that was diagnosed through a biopsy from the main lesion, with access from the esophagus, through transbronchial needle aspiration with EBUS, under general anesthesia and intubation. Staging with transbronchial needle aspiration with EBUS was also performed at the same session.

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Xu, Chunhua, Wei Wang, Qi Yuan, Huidi Hu, Li Li, and Rusong Yang. "Rapid On-Site Evaluation During Radial Endobronchial Ultrasound–Guided Transbronchial Lung Biopsy for the Diagnosis of Peripheral Pulmonary Lesions." Technology in Cancer Research & Treatment 19 (January 1, 2020): 153303382094748. http://dx.doi.org/10.1177/1533033820947482.

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Objective: To evaluate the diagnostic value of radial endobronchial ultrasound (R-EBUS) combination with rapid on-site evaluation (ROSE) guided transbronchial lung biopsy (TBLB) for peripheral pulmonary lesions. Methods: Peripheral pulmonary lesions identified by computed tomography underwent R-EBUS with or without ROSE randomly from February 2016 to August 2017. The diagnostic yield and the operation time were compared. Results: In total, 158 patients were involved in and completed this research, including 84 cases in the group of R-EBUS with ROSE, and 74 in the group without ROSE. The diagnostic yield of ROSE group was 85.7%. Among these positive cases, 69.4% cases were malignant tumors, and 30.6% cases were benign lesions. The operation time was (24.6 ± 6.3) min. In the group without ROSE, the diagnostic yield was 70.3%, including 35 malignant tumors (67.3%), and 17 benign lesions (32.7%). The operation time was (31.5 ± 6.8) min. There were significant differences between both groups in the diagnostic yield (χ2 = 5.556, P = 0.018) and in the operation time (t = 3.187, P < 0.01). No serious procedure related complications were observed, such as pneumothorax and hemorrhage. Conclusion: ROSE can improve the diagnostic yield, and shorten the operation time. R-EBUS combined with ROSE is a safe and effective technique for peripheral pulmonary lesions.

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Belanger, Adam R., and Jason A. Akulian. "An update on the role of advanced diagnostic bronchoscopy in the evaluation and staging of lung cancer." Therapeutic Advances in Respiratory Disease 11, no. 5 (March 8, 2017): 211–21. http://dx.doi.org/10.1177/1753465817695981.

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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. We conclude with a discussion of the comparison of the various methodologies.

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Guarize, Juliana, Stefano Donghi, Maurício Guidi Saueressig, Marcia Jacomelli, Sergio Eduardo Demarzo, Paulo Francisco Guerreiro Cardoso, Addy Lidvina Mejia Palomino, and Viviane Rossi Figueiredo. "Radial-probe EBUS for the diagnosis of peripheral pulmonary lesions." Jornal Brasileiro de Pneumologia 43, no. 1 (February 2017): 76–77. http://dx.doi.org/10.1590/s1806-37562016000000379.

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Liu, Nana, Jianying Kan, Wenbin Cao, Jie Cao, Erlie Jiang, Yang Zhou, Mingfeng Zhao, and Jing Feng. "Metagenomic next-generation sequencing diagnosis of peripheral pulmonary infectious lesions through virtual navigation, radial EBUS, ultrathin bronchoscopy, and ROSE." Journal of International Medical Research 47, no. 10 (August 22, 2019): 4878–85. http://dx.doi.org/10.1177/0300060519866953.

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Objective To evaluate the efficacy of combined rapid on-site evaluation of cytology (ROSE), ultrathin bronchoscopy, virtual bronchoscopic navigation, radial endobronchial ultrasound (EBUS), and metagenomic next-generation sequencing (mNGS) for diagnosis of peripheral pulmonary infectious lesions. Methods Specimens from patients with peripheral lung infection were obtained by transbronchial lung biopsy (TBLB) and bronchoalveolar lavage (BAL), and mNGS was used to detect pathogenic microorganisms. The sensitivity and specificity of mNGS were compared between TBLB tissue and BAL fluid. Results The most common pathogens of pulmonary infectious lesions in this study were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. The specificity of mNGS was higher in TBLB tissue than in BAL fluid, but mNGS of BAL fluid had higher sensitivity. Conclusions The combination of ROSE, ultrathin bronchoscopy, virtual bronchoscopic navigation, radial EBUS, and mNGS technology yielded high efficacy for the diagnosis of peripheral pulmonary infectious lesions. TBLB and BAL specimens have respective advantages in specificity and sensitivity for mNGS analysis.

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Zarogoulidis, Paul, Christoforos S. Kosmidis, Wolfgang Hohenforst-Schmidt, Dimitrios Matthaios, Konstantinos Sapalidis, Dimitrios Petridis, Eleni-Isidora Perdikouri, et al. "Radial-EBUS: CryoBiopsy Versus Conventional Biopsy: Time-Sample and C-Arm." International Journal of Environmental Research and Public Health 19, no. 6 (March 17, 2022): 3569. http://dx.doi.org/10.3390/ijerph19063569.

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Introduction: Diagnosis of lung nodules is still under investigation. We use computed tomography scans and positron emission tomography in order to identify their origin. Patients and Methods: In our retrospective study, we included 248 patients with a single lung nodule or multiple lung nodules of size ≥1 cm. We used a radial-endobronchial ultrasound and a C-Arm. We used a 1.1 mm cryoprobe versus a 22G needle vs. forceps/brush. We compared the sample size of each biopsy method with the number of cell-block slices. Results: Central lesions indifferent to the method provided the same mean number of cell-block slices (0.04933–0.02410). Cryobiopsies provide less sample size for peripheral lesions due to the higher incidence of pneumothorax (0.04700–0.02296). Conclusion: The larger the lesion ≥2 cm, and central, more cell-blocks are produced indifferent to the biopsy method (0.13386–0.02939). The time of the procedure was observed to be less when the C-Arm was used as an additional navigation tool (0.14854–0.00089).

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Azcuna, Helena, Julio Pérez Izquierdo, Jose Javier Echeverria, Luis Tena, Mikel Egurrola, Sandra Dorado, Ane Uranga, et al. "Radial Endobronchial Ultrasonography (EBUS) in the Diagnosis of Peripheral Pulmonary Lesions." Chest 145, no. 3 (March 2014): 490A. http://dx.doi.org/10.1378/chest.1824356.

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Srikanthan, K., C. Drouot, B. Sukumaran, V. Johnson, M. Walshaw, and K. Mohan. "P16 Radial ebus biopsy with guide sheath for peripheral pulmonary lesions." Thorax 71, Suppl 3 (November 15, 2016): A92.1—A92. http://dx.doi.org/10.1136/thoraxjnl-2016-209333.159.

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Fournier, C., X. Dhalluin, M. C. Copin, B. Bouchindhomme, and F. Wallyn. "Ponctions transbronchiques distales de lésions exobronchiques après repérage en Ebus Radial." Revue des Maladies Respiratoires 36 (January 2019): A230. http://dx.doi.org/10.1016/j.rmr.2018.10.525.

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Blanco, Jose Garcia, Sisir Akkineni, Brian Cody Adkinson, and Sixto Arias. "RADIAL EBUS: IMPORTANT TOOL TO DIAGNOSE ELECRONIC/VAPING-INDUCED LUNG INJURY." Chest 158, no. 4 (October 2020): A1910. http://dx.doi.org/10.1016/j.chest.2020.08.1655.

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Chambers, David, Umair Gauhar, and Rodrigo Cavallazzi. "Impact of Introduction of Radial EBUS at a VA Medical Center." Chest 150, no. 4 (October 2016): 1021A. http://dx.doi.org/10.1016/j.chest.2016.08.1127.

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Lee, Jaemin, Changhwan Kim, Hee Yun Seol, Hyeon Sung Chung, Jeongha Mok, Geewon Lee, Eun Jong Jo, et al. "Safety and Diagnostic Yield of Radial Probe Endobronchial Ultrasound-Guided Biopsy for Peripheral Lung Lesions in Patients with Idiopathic Pulmonary Fibrosis: A Multicenter Cross-Sectional Study." Respiration 101, no. 4 (November 19, 2021): 401–7. http://dx.doi.org/10.1159/000520034.

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Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) is widely used for diagnosis of peripheral lung lesions (PLLs). To date, there have been no reports regarding the clinical outcomes of RP-EBUS-TBLB for PLLs in patients with idiopathic pulmonary fibrosis (IPF). Objectives: This study was performed between October 2017 and December 2019 to identify the safety and diagnostic performance of RP-EBUS-TBLB in IPF patients. Methods: Patients were divided into the usual interstitial pneumonia (UIP) group (n = 39, 4%), the probable UIP group (n = 12, 1%), and the noninterstitial lung disease (non-ILD) group (n = 903, 95%). Results: The diagnostic yield was significantly lower in the UIP group than in the non-ILD group (62% vs. 76%; p = 0.042), but there were no significant differences between the UIP and probable UIP groups (62% vs. 83%; p = 0.293) or the probable UIP and non-ILD groups (83% vs. 76%; p = 0.741). Multivariate logistic analysis showed that the mean diameter of PLLs, positive bronchus sign on CT, and “within the lesion” status on EBUS were independently associated with success of the procedure. Especially, the presence of the UIP pattern on CT (OR, 0.385; 95% CI: 0.172–0.863; p = 0.020) was independently associated with failed diagnosis. Among patients with UIP, “within the lesion” status on EBUS (OR, 25.432; 95% CI: 2.321–278.666; p = 0.008) was shown to be a factor contributing to a successful diagnosis. Overall, there were no significant differences in complication rates among the 3 study groups. Conclusion: RP-EBUS-TBLB can be performed safely with an acceptable diagnostic yield, even in patients with IPF.

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Kempa, Axel Tobias. "Lungenfibrose: Diagnostik peripherer Lungenläsionen nicht verzögern." Kompass Pneumologie 10, no. 1 (2022): 21–23. http://dx.doi.org/10.1159/000521341.

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Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) is widely used for diagnosis of peripheral lung lesions (PLLs). To date, there have been no reports regarding the clinical outcomes of RPEBUS-TBLB for PLLs in patients with idiopathic pulmonary fibrosis (IPF). Objectives: This study was performed between October 2017 and December 2019 to identify the safety and diagnostic performance of RP-EBUS-TBLB in IPF patients. Methods: Patients were divided into the usual interstitial pneumonia (UIP) group (n =39, 4%), the probable UIP group (n = 12, 1%), and the noninterstitial lung disease (non-ILD) group (n = 903, 95%). Results: The diagnostic yield was significantly lower in the UIP group than in the non-ILD group (62% vs. 76%; p = 0.042), but there were no significant differences between the UIP and probable UIP groups (62% vs. 83%; p = 0.293) or the probable UIP and non-ILD groups (83% vs. 76%; p = 0.741). Multivariate logistic analysis showed that the mean diameter of PLLs, positive bronchus sign on CT, and «within the lesion» status on EBUS were independently associated with success of the procedure. Especially, the presence of the UIP pattern on CT (OR, 0.385; 95% CI: 0.172–0.863; p = 0.020) was independently associated with failed diagnosis. Among patients with UIP, «within the lesion» status on EBUS (OR, 25.432; 95% CI: 2.321–278.666; p = 0.008) was shown to be a factor contributing to a successful diagnosis. Overall, there were no significant differences in complication rates among the 3 study groups. Conclusion: RPEBUS-TBLB can be performed safely with an acceptable diagnostic yield, even in patients with IPF.

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Wang, Wei, Like Yu, Yuchao Wang, Qian Zhang, Chuanzhen Chi, Ping Zhan, and Chunhua Xu. "Radial EBUS versus CT-guided needle biopsy for evaluation of solitary pulmonary nodules." Oncotarget 9, no. 19 (January 4, 2018): 15122–31. http://dx.doi.org/10.18632/oncotarget.23952.

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Guvenc, Canan, Jonas Yserbyt, Dries Testelmans, Federica Zanca, An Carbonez, Vincent Ninane, Walter De Wever, and Christophe Dooms. "Computed Tomography Characteristics Predictive for Radial EBUS-Miniprobe-Guided Diagnosis of Pulmonary Lesions." Journal of Thoracic Oncology 10, no. 3 (March 2015): 472–78. http://dx.doi.org/10.1097/jto.0000000000000410.

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Abbasi, Mohammed, Nathaniel Moulton, Danish Ahmad, Allen Cole Burks, Praveen Chenna, Kevin Haas, Andrea Loiselle, et al. "REFINING RADIAL EBUS: CHARACTERIZING IMAGING INTERPRETATION AND PROPOSAL FOR A STANDARDIZED GRADING SYSTEM." Chest 158, no. 4 (October 2020): A1936—A1937. http://dx.doi.org/10.1016/j.chest.2020.08.1676.

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Simon, Mărioara, Ioan Simon, Paul Andrei Tent, Doina Adina Todea, and Antonia Haranguș. "Cryobiopsy in Lung Cancer Diagnosis—A Literature Review." Medicina 57, no. 4 (April 19, 2021): 393. http://dx.doi.org/10.3390/medicina57040393.

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Optimizing the diagnosis of lung cancer represents a challenge, as well as a necessity, for improving the low survival of these patients. Flexible bronchoscopy with forceps biopsy is one of the key diagnostic procedures used for lung tumors. The small sample size and crush artifacts are several factors that can often limit access to a complete diagnosis, therefore leading to the need of repeating the bronchoscopy procedure or other invasive diagnostic methods. The bronchoscopic cryobiopsy is a recent technique that proved its utility in the diagnosis of both endobronchial and peripheral lung tumors. In comparison with conventional forceps biopsy, studies report a higher diagnostic yield and a superior quality of the collected samples for both the histopathological and the molecular diagnosis of lung cancer. This method shows promising results in sampling lung tissue, alone, or in conjunction with fluoroscopy or radial endobronchial ultrasound (r-EBUS). With a good safety and cost-benefit profile, this novel method has the potential to improve the diagnosis, and therefore the management of lung cancer patients. The objective of this narrative review is to provide a comprehensive review of the recent data regarding the advantages of cryobiopsy and r-EBUS in lung cancer diagnosis.

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Ho, Elliot, Roy Joseph Cho, Joseph C. Keenan, and Septimiu Murgu. "The Feasibility of Using the “Artery Sign” for Pre-Procedural Planning in Navigational Bronchoscopy for Parenchymal Pulmonary Lesion Sampling." Diagnostics 12, no. 12 (December 6, 2022): 3059. http://dx.doi.org/10.3390/diagnostics12123059.

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Background: Electromagnetic navigation bronchoscopy (ENB) and robotic-assisted bronchoscopy (RAB) systems are used for pulmonary lesion sampling, and utilize a pre-procedural CT scan where an airway, or “bronchus sign”, is used to map a pathway to the target lesion. However, up to 40% of pre-procedural CT’s lack a “bronchus sign” partially due to surrounding emphysema or limitation in CT resolution. Recognizing that the branches of the pulmonary artery, lymphatics, and airways are often present together as the bronchovascular bundle, we postulate that a branch of the pulmonary artery (“artery sign”) could be used for pathway mapping during navigation bronchoscopy when a “bronchus sign” is absent. Herein we describe the navigation success and safety of using the “artery sign” to create a pathway for pulmonary lesion sampling. Methods: We reviewed data on consecutive cases in which the “artery sign” was used for pre-procedural planning for conventional ENB (superDimension™, Medtronic) and RAB (Monarch™, Johnson & Johnson). Patients who underwent these procedures from July 2020 until July 2021 at the University of Minnesota Medical Center and from June 2018 until December 2019 at the University of Chicago Medical Center were included in this analysis (IRB #19-0011 for the University of Chicago and IRB #00013135 for the University of Minnesota). The primary outcome was navigation success, defined as successfully maneuvering the bronchoscope to the target lesion based on feedback from the navigation system. Secondary outcomes included navigation success based on radial EBUS imaging, pneumothorax, and bleeding rates. Results: A total of 30 patients were enrolled in this analysis. The median diameter of the lesions was 17 mm. The median distance of the lesion from the pleura was 5 mm. Eleven lesions were solid, 15 were pure ground glass, and 4 were mixed. All cases were planned successfully using the “artery sign” on either the superDimension™ ENB (n = 15) or the Monarch™ RAB (n = 15). Navigation to the target was successful for 29 lesions (96.7%) based on feedback from the navigation system (virtual target). Radial EBUS image was acquired in 27 cases (90%) [eccentric view in 13 (43.33%) and concentric view in 14 patients (46.66%)], while in 3 cases (10%) no r-EBUS view was obtained. Pneumothorax occurred in one case (3%). Significant airway bleeding was reported in one case (3%). Conclusions: We describe the concept of using the “artery sign” as an alternative for planning EMN and RAB procedures when “bronchus sign” is absent. The navigation success based on virtual target or r-EBUS imaging is high and safety of sampling of such lesions compares favorably with prior reports. Prospective studies are needed to assess the impact of the “artery sign” on diagnostic yield.

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Goel, Manoj K., Ajay Kumar, Gargi Maitra, Balkar Singh, Sunita Ahlawat, Priti Jain, Neeraj Garg, and Radha Krishan Verma. "Radial EBUS-Guided Cryobiopsy of Peripheral Lung Lesions With Flexible Bronchoscopy Without Using Guide-Sheath." Journal of Bronchology & Interventional Pulmonology 28, no. 3 (April 1, 2021): 184–91. http://dx.doi.org/10.1097/lbr.0000000000000768.

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Zaric, Bojan, Vladimir Stojsic, Vladimir Carapic, Tomi Kovacevic, Goran Stojanovic, Milana Panjkovic, Ioannis Kioumis, et al. "Radial Endobronchial Ultrasound (EBUS) Guided Suction Catheter-Biopsy in Histological Diagnosis of Peripheral Pulmonary Lesions." Journal of Cancer 7, no. 1 (2016): 7–13. http://dx.doi.org/10.7150/jca.13081.

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Guisier, Florian, Mathieu Salaün, Samy Lachkar, Aude Lamy, Nicolas Piton, Bérengère Obstoy, Jean-Christophe Sabourin, and Luc Thiberville. "Molecular analysis of peripheral non-squamous non-small cell lung cancer sampled by radial EBUS." Respirology 21, no. 4 (January 27, 2016): 718–26. http://dx.doi.org/10.1111/resp.12737.

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Liam, C.-K., P. Lee, C.-J. Yu, C. Bai, and K. Yasufuku. "The diagnosis of lung cancer in the era of interventional pulmonology." International Journal of Tuberculosis and Lung Disease 25, no. 1 (January 1, 2021): 6–15. http://dx.doi.org/10.5588/ijtld.20.0588.

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Advances in bronchoscopic and other interventional pulmonology technologies have expanded the sampling procedures pulmonologist can use to diagnose lung cancer and accurately stage the mediastinum. Among the modalities available to the interventional pulmonologist are endobronchial ultrasound-guided transbronchial needles aspiration (EBUS-TBNA) and transoesophageal bronchoscopic ultrasound-guided fine-needle aspiration (EUS-B-FNA) for sampling peribronchial/perioesophageal central lesions and for mediastinal lymph node staging, as well as navigational bronchoscopy and radial probe endobronchial ultrasound (RP-EBUS) for the diagnosis of peripheral lung cancer. The role of the interventional pulmonologist in this setting is to apply these procedures based on the correct interpretation of clinical and radiological findings in order to maximise the chances of achieving the diagnosis and obtaining sufficient tissue for molecular biomarker testing to guide targeted therapies for advanced non-small cell lung cancer. The safest and the highest diagnosis-yielding modality should be chosen to avoid a repeat sampling procedure if the first one is non-diagnostic. The choice of site and biopsy modality are influenced by tumour location, patient comorbidities, availability of equipment and local expertise. This review provides a concise state-of-the art account of the interventional pulmonology procedures in the diagnosis and staging of lung cancer.

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Durakovic, Amal, Henrik Andersen, Anders Christiansen, and Irena Hammen. "Retrospective analysis of radial EBUS outcome for the diagnosis of peripheral pulmonary lesion: sensitivity and complications." European Clinical Respiratory Journal 2, no. 1 (January 1, 2015): 28947. http://dx.doi.org/10.3402/ecrj.v2.28947.

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Kurimoto, Noriaki, and Haruhiko Nakamura. "Endobronchial ultrasonography (EBUS) using a radial ultrasound miniature probe for peripheral pulmonary lesions: tips and techniques." Current Pulmonology Reports 5, no. 4 (October 13, 2016): 199–203. http://dx.doi.org/10.1007/s13665-016-0157-5.

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Xia, Yang, Qin Li, Changgao Zhong, Kopen Wang, and Shiyue Li. "Inheritance and innovation of the diagnosis of peripheral pulmonary lesions." Therapeutic Advances in Chronic Disease 14 (January 2023): 204062232211467. http://dx.doi.org/10.1177/20406223221146723.

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As the leading cause of cancer-related deaths worldwide, early detection and diagnosis are crucial to reduce the mortality of lung cancer. To date, the diagnosis of the peripheral pulmonary lesions (PPLs) remains a major unmet clinical need. The urgency of diagnosing PPLs has driven a series of development of the advanced bronchoscopy-guided techniques in the past decades, such as radial probe-endobronchial ultrasonography (RP-EBUS), virtual bronchoscopy navigation (VBN), electromagnetic navigation bronchoscopy (ENB), bronchoscopic transparenchymal nodule access (BTPNA), and robotic-assisted bronchoscopy. However, these techniques also have their own limitations. In this review, we would like to introduce the development of diagnostic techniques for PPLs, with a special focus on biopsy approaches and advanced guided bronchoscopy techniques by discussing their advantages, limitations, and future prospects.

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Ankudavicius, Vytautas, Skaidrius Miliauskas, Lina Poskiene, Donatas Vajauskas, and Marius Zemaitis. "Diagnostic Yield of Transbronchial Cryobiopsy Guided by Radial Endobronchial Ultrasound and Fluoroscopy in the Radiologically Suspected Lung Cancer: A Single Institution Prospective Study." Cancers 14, no. 6 (March 18, 2022): 1563. http://dx.doi.org/10.3390/cancers14061563.

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Transbronchial cryobiopsy (TBCB) is being studied in the diagnosis of peripheral lung lesions; however, there are only a few clinical studies around the world. The aim of our study was to evaluate the diagnostic values and safety of transbronchial cryobiopsy for radiologically suspected peripheral lung cancer. The prospective clinical study was executed from September 2019 to September 2021 at a tertiary clinical centre in Lithuania. A total of 48 patients out of 102 underwent combined procedures of transbronchial forceps biopsy (TBFB) and TBCB. Diagnostic values and safety outcomes of TBFB and TBCB were analysed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 72.9%, 100%, 100%, 7.7%, and 88.0% for TBFB, 85.1%, 100%, 100%, 12.5%, and 93% for TBCB, as well as 91.5%, 100%, 100%, 20.0% and 96.7% for the combined procedures, respectively, with a significantly higher accuracy for cryobiopsies compared to forceps biopsies (p < 0.05). The diagnostic values for transbronchial cryobiopsies were similar, irrespective of the radial mini probe endobronchial ultrasound (RP-EBUS) position, lesion size or bronchus sign, however, the sensitivity of the combined procedures in cases with RP-EBUS adjacent to the target was significantly higher compared to TBFB (86.2% vs. 64.3%, p = 0.016). Samples of cryobiopsies were significantly larger than forceps biopsies (34.62 mm2 vs. 4.4 mm2, p = 0.001). The cumulative diagnostic yield of transbronchial cryobiopsy was 80.0% after the second biopsy and reached a plateau of 84.1% after four biopsies. No severe bleeding, pneumothorax, respiratory failure or death was registered in our study. TBCB is a potentially safe procedure, which increases diagnostic values in diagnosing peripheral lung lesions compared to TBFB.

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Nguyen, Sebastien, Fabien Rolland, Stephane Beaudoin, Francis Laberge, Mathieu Simon, Noel Lampron, Simon Martel, Michel Laviolette, and Antoine Delage. "Impact of Fluoroscopy on the Diagnostic Yield of Radial EBUS Probe for Peripheral Pulmonary Lesions: A Randomized Trial." Chest 148, no. 4 (October 2015): 794A. http://dx.doi.org/10.1378/chest.2257975.

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Georgiou, Harry D., John Taverner, Louis B. Irving, and Daniel P. Steinfort. "Safety and Efficacy of Radial EBUS for the Investigation of Peripheral Pulmonary Lesions in Patients With Advanced COPD." Journal of Bronchology & Interventional Pulmonology 23, no. 3 (July 2016): 192–98. http://dx.doi.org/10.1097/lbr.0000000000000288.

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Kho, S. S., M. C. Yong, S. K. Chan, and S. T. Tie. "P2.12-002 Radial Probe Endobronchial Ultrasound (R-EBUS) Guided Transbronchial Cryobiopsy In The Diagnosis of Peripheral Lung Mass." Journal of Thoracic Oncology 12, no. 11 (November 2017): S2163. http://dx.doi.org/10.1016/j.jtho.2017.09.1344.

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Hayama, Manabu, Takehiro Izumo, Christine Chavez, Yuji Matsumoto, Takaaki Tsuchida, and Shinji Sasada. "Additional transbronchial needle aspiration through a guide sheath for peripheral pulmonary lesions that cannot be detected by radial EBUS." Clinical Respiratory Journal 11, no. 6 (December 16, 2015): 757–64. http://dx.doi.org/10.1111/crj.12413.

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Journal articles on the topic 'Radial EBUS'

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