Browse > Article
http://dx.doi.org/10.4046/trd.2013.75.4.135

Technical Aspects of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration  

Kang, Hyo Jae (Department of Pulmonology, Center for Lung Cancer, National Cancer Center)
Hwangbo, Bin (Department of Pulmonology, Center for Lung Cancer, National Cancer Center)
Publication Information
Tuberculosis and Respiratory Diseases / v.75, no.4, 2013 , pp. 135-139 More about this Journal
Abstract
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is becoming a standard method for invasive mediastinal staging and for the diagnosis of paratracheal and peribronchial lesions. It is essential to understand the technical aspects of EBUS-TBNA to ensure safe and efficient procedures. In this review, we discuss the practical aspects to be considered during EBUS-TBNA, including anesthesia, manipulation of equipment, understanding mediastinal ultrasound images, target selection, number of aspirations needed per target, sample handling, and complications.
Keywords
Endobronchial Ultrasound; Bronchoscopy; Lung Neoplasm;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Krasnik M, Vilmann P, Larsen SS, Jacobsen GK. Preliminary experience with a new method of endoscopic transbronchial real time ultrasound guided biopsy for diagnosis of mediastinal and hilar lesions. Thorax 2003;58:1083-6.   DOI
2 Silvestri GA, Gonzalez AV, Jantz MA, Margolis ML, Gould MK, Tanoue LT, et al. Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013;143(5 Suppl):e211S-50S.   DOI
3 Steinfort DP, Irving LB. Patient satisfaction during endobronchial ultrasound-guided transbronchial needle aspiration performed under conscious sedation. Respir Care 2010;55:702-6.
4 Lee HJ, Haas AR, Sterman DH, Solly R, Vachani A, Gillespie CT. Pilot randomized study comparing two techniques of airway anaesthesia during curvilinear probe endobronchial ultrasound bronchoscopy (CP-EBUS). Respirology 2011;16:102-6.   DOI
5 Haas AR. Infectious complications from full extension endobronchial ultrasound transbronchial needle aspiration. Eur Respir J 2009;33:935-8.   DOI
6 Casal RF, Staerkel GA, Ost D, Almeida FA, Uzbeck MH, Eapen GA, et al. Randomized clinical trial of endobronchial ultrasound needle biopsy with and without aspiration. Chest 2012;142:568-73.   DOI
7 Fujiwara T, Yasufuku K, Nakajima T, Chiyo M, Yoshida S, Suzuki M, et al. The utility of sonographic features during endobronchial ultrasound-guided transbronchial needle aspiration for lymph node staging in patients with lung cancer: a standard endobronchial ultrasound image classification system. Chest 2010;138:641-7.   DOI
8 Memoli JS, El-Bayoumi E, Pastis NJ, Tanner NT, Gomez M, Huggins JT, et al. Using endobronchial ultrasound features to predict lymph node metastasis in patients with lung cancer. Chest 2011;140:1550-6.   DOI
9 Nakajima T, Anayama T, Shingyoji M, Kimura H, Yoshino I, Yasufuku K. Vascular image patterns of lymph nodes for the prediction of metastatic disease during EBUS-TBNA for mediastinal staging of lung cancer. J Thorac Oncol 2012;7:1009- 14.   DOI
10 Nakajima T, Anayama T, Koike T, Shingyoji M, Castle L, Kimura H, et al. Endobronchial ultrasound doppler image features correlate with mRNA expression of HIF1-alpha and VEGF-C in patients with non-small-cell lung cancer. J Thorac Oncol 2012;7:1661-7.   DOI
11 Hwangbo B, Lee GK, Lee HS, Lim KY, Lee SH, Kim HY, et al. Transbronchial and transesophageal fine-needle aspiration using an ultrasound bronchoscope in mediastinal staging of potentially operable lung cancer. Chest 2010;138:795-802.   DOI
12 Yasufuku K, Pierre A, Darling G, de Perrot M, Waddell T, Johnston M, et al. A prospective controlled trial of endobronchial ultrasound-guided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph node staging of lung cancer. J Thorac Cardiovasc Surg 2011;142:1393-400.e1.   DOI
13 Lee HS, Lee GK, Lee HS, Kim MS, Lee JM, Kim HY, et al. Realtime endobronchial ultrasound-guided transbronchial needle aspiration in mediastinal staging of non-small cell lung cancer: how many aspirations per target lymph node station? Chest 2008;134:368-74.   DOI
14 Yarmus LB, Akulian J, Lechtzin N, Yasin F, Kamdar B, Ernst A, et al. Comparison of 21-gauge and 22-gauge aspiration needle in endobronchial ultrasound-guided transbronchial needle aspiration: results of the American College of Chest Physicians Quality Improvement Registry, Education, and Evaluation Registry. Chest 2013;143:1036-43.   DOI
15 Sakairi Y, Nakajima T, Yasufuku K, Ikebe D, Kageyama H, Soda M, et al. EML4-ALK fusion gene assessment using metastatic lymph node samples obtained by endobronchial ultrasoundguided transbronchial needle aspiration. Clin Cancer Res 2010;16:4938-45.   DOI
16 Herth FJ, Morgan RK, Eberhardt R, Ernst A. Endobronchial ultrasound-guided miniforceps biopsy in the biopsy of subcarinal masses in patients with low likelihood of non-small cell lung cancer. Ann Thorac Surg 2008;85:1874-8.   DOI
17 Chrissian A, Misselhorn D, Chen A. Endobronchial-ultrasound guided miniforceps biopsy of mediastinal and hilar lesions. Ann Thorac Surg 2011;92:284-8.   DOI
18 Nakajima T, Yasufuku K, Suzuki M, Hiroshima K, Kubo R, Mohammed S, et al. Assessment of epidermal growth factor receptor mutation by endobronchial ultrasound-guided transbronchial needle aspiration. Chest 2007;132:597-602.   DOI
19 Navani N, Brown JM, Nankivell M, Woolhouse I, Harrison RN, Jeebun V, et al. Suitability of endobronchial ultrasoundguided transbronchial needle aspiration specimens for subtyping and genotyping of non-small cell lung cancer: a multicenter study of 774 patients. Am J Respir Crit Care Med 2012;185:1316-22.   DOI
20 Nakajima T, Yasufuku K, Saegusa F, Fujiwara T, Sakairi Y, Hiroshima K, et al. Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for nodal staging in patients with lung cancer. Ann Thorac Surg 2013;95:1695-9.   DOI
21 Oki M, Saka H, Kitagawa C, Kogure Y, Murata N, Adachi T, et al. Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing lung cancer: a randomized study. Respiration 2013;85:486-92.   DOI
22 Polkowski M, Larghi A, Weynand B, Boustiere C, Giovannini M, Pujol B, et al. Learning, techniques, and complications of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline. Endoscopy 2012;44:190-206.   DOI
23 Gu P, Zhao YZ, Jiang LY, Zhang W, Xin Y, Han BH. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and meta-analysis. Eur J Cancer 2009;45:1389-96.   DOI
24 Eapen GA, Shah AM, Lei X, Jimenez CA, Morice RC, Yarmus L, et al. Complications, consequences, and practice patterns of endobronchial ultrasound-guided transbronchial needle aspiration: results of the AQuIRE registry. Chest 2013;143:1044- 53.   DOI
25 Huang CT, Chen CY, Ho CC, Yu CJ. A rare constellation of empyema, lung abscess, and mediastinal abscess as a complication of endobronchial ultrasound-guided transbronchial needle aspiration. Eur J Cardiothorac Surg 2011;40:264-5.   DOI
26 Stather DR, MacEachern P, Chee A, Tremblay A. Safety of endobronchial ultrasound-guided transbronchial needle aspiration for patients taking clopidogrel: a report of 12 consecutive cases. Respiration 2012;83:330-4.   DOI
27 Groth SS, Whitson BA, D'Cunha J, Maddaus MA, Alsharif M, Andrade RS. Endobronchial ultrasound-guided fine-needle aspiration of mediastinal lymph nodes: a single institution's early learning curve. Ann Thorac Surg 2008;86:1104-9.   DOI
28 Abu-Hijleh M, El-Sameed Y, Eldridge K, Vadia E, Chiu H, Dreyfuss Z, et al. Linear probe endobronchial ultrasound bronchoscopy with guided transbronchial needle aspiration (EBUS-TBNA) in the evaluation of mediastinal and hilar pathology: introducing the procedure to a teaching institution. Lung 2013;191:109-15.   DOI
29 Stather DR, MacEachern P, Chee A, Dumoulin E, Tremblay A. Evaluation of clinical endobronchial ultrasound skills following clinical versus simulation training. Respirology 2012;17:291-9.   DOI
30 Kemp SV, El Batrawy SH, Harrison RN, Skwarski K, Munavvar M, Rosell A, et al. Learning curves for endobronchial ultrasound using cusum analysis. Thorax 2010;65:534-8.   DOI
31 Davoudi M, Colt HG, Osann KE, Lamb CR, Mullon JJ. Endobronchial ultrasound skills and tasks assessment tool: assessing the validity evidence for a test of endobronchial ultrasound-guided transbronchial needle aspiration operator skill. Am J Respir Crit Care Med 2012;186:773-9.   DOI