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. 2022 Oct;200(5):643-648.
doi: 10.1007/s00408-022-00563-w. Epub 2022 Sep 8.

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

Atsushi Torii  1 , Masahide Oki  2 , Arisa Yamada  2 , Yoshihito Kogure  2 , Chiyoe Kitagawa  2 , Hideo Saka  2
Affiliations

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

Atsushi Torii et al. Lung. 2022 Oct.

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.

Keywords: Diagnostic bronchoscopy; Diagnostic yield; Endobronchial ultrasound bronchoscopes; Endobronchial ultrasound-guided transbronchial needle aspiration; Endoscopic ultrasound with bronchoscope-guided fine needle aspiration intrathoracic lesion.

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