Radial probe endobronchial ultrasound assisted conventional transbronchial needle aspiration in the diagnosis of solitary peribronchial pulmonary lesion located in the segmental bronchi

Zhiang Huang, Haidong Huang, Jin Han, Yunye Ning, Yibo Shen, Hui Shi, Qin Wang, Chong Bai, Qiang Li, Simoff Michael, Paul Zarogoulidis, Wolfgang Hohenforst-Schmidt, Fotis Konstantinou, J. Turner, Charilaos Koulouris, Athanasios Katsaounis, Aikaterini Amaniti, Stylianos Mantalovas, Efstathios Pavlidis, Dimitrios Giannakidis & 5 others Ioannis Passos, Nikolaos Michalopoulos, Christoforos Kosmidis, Stelian Ştefăniţă Mogoantă, Konstantinos Sapalidis

Research output: Contribution to journalArticle

Abstract

Background: The diagnosis of peribronchial pulmonary lesions located in the tertiary bronchi, also known as segmental bronchi, as well as, the 4th order and 5th order segmental bronchi is very difficult. Histopathological specimens cannot be easily obtained by endobronchial biopsies (EBBX) due to the patent but small segmental bronchial lumen. The aim of the present study was to evaluate the diagnostic accuracy and safety of the novel technique with radial probe endobronchial ultrasound (R-EBUS) assisted conventional transbronchial needle aspiration (C-TBNA) in the diagnosis of solitary peribronchial pulmonary lesions located in segmental bronchi from 3th to 5th order. Methods: From December 2014 to December 2015, 16 patients with solitary peribronchial pulmonary lesions in the segmental bronchi from 3th to 5th order confirmed by computed tomography (CT) were enrolled. The lesions were located using radial probe endobronchial ultrasound (R-EBUS) to determine the sites of conventional transbronchial needle aspiration (C-TBNA), then, histopathological specimens were obtained using the technique of C-TBNA. The final pathological diagnosis was made based on the findings from the surgical specimens. Statistical analyses were performed for specimen results and complications. Results: On pathological evaluation, 14 of the 16 specimens were malignant, including 8 adenocarcinomas, 4 squamous cell carcinomas, and 2 small cell carcinomas, while 2 were non-malignant diseases. The diagnostic accuracy rate, sensitivity and missed diagnosis rates were 87.5%, 87.5% and 12.5%, respectively. When Combined the results of cytology with histologic samples obtained from C-TBNA the total diagnostic accuracy rate, sensitivity and missed diagnosis rate were 93.75%, 93.75% and 6.25%, respectively. There were 2 cases of bleeding complications >5 mL after C-TBNA, and both were resolved with endobronchial management. Conclusions: The combination of R-EBUS with C-TBNA was advantageous and safe for the diagnosis of solitary peribronchial pulmonary lesions located in the segmental bronchi. However, possible bleeding complications should be anticipated with needle aspiration. Further verification of this combined application should be investigated in larger clinical trials.

Original languageEnglish (US)
Pages (from-to)634-642
Number of pages9
JournalJournal of Cancer
Volume10
Issue number3
DOIs
StatePublished - Jan 1 2019

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Bronchi
Needles
Lung
Hemorrhage
Small Cell Carcinoma
Cell Biology
Squamous Cell Carcinoma
Adenocarcinoma
Tomography
Clinical Trials
Biopsy
Safety

All Science Journal Classification (ASJC) codes

  • Oncology

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Radial probe endobronchial ultrasound assisted conventional transbronchial needle aspiration in the diagnosis of solitary peribronchial pulmonary lesion located in the segmental bronchi. / Huang, Zhiang; Huang, Haidong; Han, Jin; Ning, Yunye; Shen, Yibo; Shi, Hui; Wang, Qin; Bai, Chong; Li, Qiang; Michael, Simoff; Zarogoulidis, Paul; Hohenforst-Schmidt, Wolfgang; Konstantinou, Fotis; Turner, J.; Koulouris, Charilaos; Katsaounis, Athanasios; Amaniti, Aikaterini; Mantalovas, Stylianos; Pavlidis, Efstathios; Giannakidis, Dimitrios; Passos, Ioannis; Michalopoulos, Nikolaos; Kosmidis, Christoforos; Mogoantă, Stelian Ştefăniţă; Sapalidis, Konstantinos.

In: Journal of Cancer, Vol. 10, No. 3, 01.01.2019, p. 634-642.

Research output: Contribution to journalArticle

Huang, Z, Huang, H, Han, J, Ning, Y, Shen, Y, Shi, H, Wang, Q, Bai, C, Li, Q, Michael, S, Zarogoulidis, P, Hohenforst-Schmidt, W, Konstantinou, F, Turner, J, Koulouris, C, Katsaounis, A, Amaniti, A, Mantalovas, S, Pavlidis, E, Giannakidis, D, Passos, I, Michalopoulos, N, Kosmidis, C, Mogoantă, SŞ & Sapalidis, K 2019, 'Radial probe endobronchial ultrasound assisted conventional transbronchial needle aspiration in the diagnosis of solitary peribronchial pulmonary lesion located in the segmental bronchi', Journal of Cancer, vol. 10, no. 3, pp. 634-642. https://doi.org/10.7150/jca.28755
Huang, Zhiang ; Huang, Haidong ; Han, Jin ; Ning, Yunye ; Shen, Yibo ; Shi, Hui ; Wang, Qin ; Bai, Chong ; Li, Qiang ; Michael, Simoff ; Zarogoulidis, Paul ; Hohenforst-Schmidt, Wolfgang ; Konstantinou, Fotis ; Turner, J. ; Koulouris, Charilaos ; Katsaounis, Athanasios ; Amaniti, Aikaterini ; Mantalovas, Stylianos ; Pavlidis, Efstathios ; Giannakidis, Dimitrios ; Passos, Ioannis ; Michalopoulos, Nikolaos ; Kosmidis, Christoforos ; Mogoantă, Stelian Ştefăniţă ; Sapalidis, Konstantinos. / Radial probe endobronchial ultrasound assisted conventional transbronchial needle aspiration in the diagnosis of solitary peribronchial pulmonary lesion located in the segmental bronchi. In: Journal of Cancer. 2019 ; Vol. 10, No. 3. pp. 634-642.
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abstract = "Background: The diagnosis of peribronchial pulmonary lesions located in the tertiary bronchi, also known as segmental bronchi, as well as, the 4th order and 5th order segmental bronchi is very difficult. Histopathological specimens cannot be easily obtained by endobronchial biopsies (EBBX) due to the patent but small segmental bronchial lumen. The aim of the present study was to evaluate the diagnostic accuracy and safety of the novel technique with radial probe endobronchial ultrasound (R-EBUS) assisted conventional transbronchial needle aspiration (C-TBNA) in the diagnosis of solitary peribronchial pulmonary lesions located in segmental bronchi from 3th to 5th order. Methods: From December 2014 to December 2015, 16 patients with solitary peribronchial pulmonary lesions in the segmental bronchi from 3th to 5th order confirmed by computed tomography (CT) were enrolled. The lesions were located using radial probe endobronchial ultrasound (R-EBUS) to determine the sites of conventional transbronchial needle aspiration (C-TBNA), then, histopathological specimens were obtained using the technique of C-TBNA. The final pathological diagnosis was made based on the findings from the surgical specimens. Statistical analyses were performed for specimen results and complications. Results: On pathological evaluation, 14 of the 16 specimens were malignant, including 8 adenocarcinomas, 4 squamous cell carcinomas, and 2 small cell carcinomas, while 2 were non-malignant diseases. The diagnostic accuracy rate, sensitivity and missed diagnosis rates were 87.5{\%}, 87.5{\%} and 12.5{\%}, respectively. When Combined the results of cytology with histologic samples obtained from C-TBNA the total diagnostic accuracy rate, sensitivity and missed diagnosis rate were 93.75{\%}, 93.75{\%} and 6.25{\%}, respectively. There were 2 cases of bleeding complications >5 mL after C-TBNA, and both were resolved with endobronchial management. Conclusions: The combination of R-EBUS with C-TBNA was advantageous and safe for the diagnosis of solitary peribronchial pulmonary lesions located in the segmental bronchi. However, possible bleeding complications should be anticipated with needle aspiration. Further verification of this combined application should be investigated in larger clinical trials.",
author = "Zhiang Huang and Haidong Huang and Jin Han and Yunye Ning and Yibo Shen and Hui Shi and Qin Wang and Chong Bai and Qiang Li and Simoff Michael and Paul Zarogoulidis and Wolfgang Hohenforst-Schmidt and Fotis Konstantinou and J. Turner and Charilaos Koulouris and Athanasios Katsaounis and Aikaterini Amaniti and Stylianos Mantalovas and Efstathios Pavlidis and Dimitrios Giannakidis and Ioannis Passos and Nikolaos Michalopoulos and Christoforos Kosmidis and Mogoantă, {Stelian Ştefăniţă} and Konstantinos Sapalidis",
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language = "English (US)",
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TY - JOUR

T1 - Radial probe endobronchial ultrasound assisted conventional transbronchial needle aspiration in the diagnosis of solitary peribronchial pulmonary lesion located in the segmental bronchi

AU - Huang, Zhiang

AU - Huang, Haidong

AU - Han, Jin

AU - Ning, Yunye

AU - Shen, Yibo

AU - Shi, Hui

AU - Wang, Qin

AU - Bai, Chong

AU - Li, Qiang

AU - Michael, Simoff

AU - Zarogoulidis, Paul

AU - Hohenforst-Schmidt, Wolfgang

AU - Konstantinou, Fotis

AU - Turner, J.

AU - Koulouris, Charilaos

AU - Katsaounis, Athanasios

AU - Amaniti, Aikaterini

AU - Mantalovas, Stylianos

AU - Pavlidis, Efstathios

AU - Giannakidis, Dimitrios

AU - Passos, Ioannis

AU - Michalopoulos, Nikolaos

AU - Kosmidis, Christoforos

AU - Mogoantă, Stelian Ştefăniţă

AU - Sapalidis, Konstantinos

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The diagnosis of peribronchial pulmonary lesions located in the tertiary bronchi, also known as segmental bronchi, as well as, the 4th order and 5th order segmental bronchi is very difficult. Histopathological specimens cannot be easily obtained by endobronchial biopsies (EBBX) due to the patent but small segmental bronchial lumen. The aim of the present study was to evaluate the diagnostic accuracy and safety of the novel technique with radial probe endobronchial ultrasound (R-EBUS) assisted conventional transbronchial needle aspiration (C-TBNA) in the diagnosis of solitary peribronchial pulmonary lesions located in segmental bronchi from 3th to 5th order. Methods: From December 2014 to December 2015, 16 patients with solitary peribronchial pulmonary lesions in the segmental bronchi from 3th to 5th order confirmed by computed tomography (CT) were enrolled. The lesions were located using radial probe endobronchial ultrasound (R-EBUS) to determine the sites of conventional transbronchial needle aspiration (C-TBNA), then, histopathological specimens were obtained using the technique of C-TBNA. The final pathological diagnosis was made based on the findings from the surgical specimens. Statistical analyses were performed for specimen results and complications. Results: On pathological evaluation, 14 of the 16 specimens were malignant, including 8 adenocarcinomas, 4 squamous cell carcinomas, and 2 small cell carcinomas, while 2 were non-malignant diseases. The diagnostic accuracy rate, sensitivity and missed diagnosis rates were 87.5%, 87.5% and 12.5%, respectively. When Combined the results of cytology with histologic samples obtained from C-TBNA the total diagnostic accuracy rate, sensitivity and missed diagnosis rate were 93.75%, 93.75% and 6.25%, respectively. There were 2 cases of bleeding complications >5 mL after C-TBNA, and both were resolved with endobronchial management. Conclusions: The combination of R-EBUS with C-TBNA was advantageous and safe for the diagnosis of solitary peribronchial pulmonary lesions located in the segmental bronchi. However, possible bleeding complications should be anticipated with needle aspiration. Further verification of this combined application should be investigated in larger clinical trials.

AB - Background: The diagnosis of peribronchial pulmonary lesions located in the tertiary bronchi, also known as segmental bronchi, as well as, the 4th order and 5th order segmental bronchi is very difficult. Histopathological specimens cannot be easily obtained by endobronchial biopsies (EBBX) due to the patent but small segmental bronchial lumen. The aim of the present study was to evaluate the diagnostic accuracy and safety of the novel technique with radial probe endobronchial ultrasound (R-EBUS) assisted conventional transbronchial needle aspiration (C-TBNA) in the diagnosis of solitary peribronchial pulmonary lesions located in segmental bronchi from 3th to 5th order. Methods: From December 2014 to December 2015, 16 patients with solitary peribronchial pulmonary lesions in the segmental bronchi from 3th to 5th order confirmed by computed tomography (CT) were enrolled. The lesions were located using radial probe endobronchial ultrasound (R-EBUS) to determine the sites of conventional transbronchial needle aspiration (C-TBNA), then, histopathological specimens were obtained using the technique of C-TBNA. The final pathological diagnosis was made based on the findings from the surgical specimens. Statistical analyses were performed for specimen results and complications. Results: On pathological evaluation, 14 of the 16 specimens were malignant, including 8 adenocarcinomas, 4 squamous cell carcinomas, and 2 small cell carcinomas, while 2 were non-malignant diseases. The diagnostic accuracy rate, sensitivity and missed diagnosis rates were 87.5%, 87.5% and 12.5%, respectively. When Combined the results of cytology with histologic samples obtained from C-TBNA the total diagnostic accuracy rate, sensitivity and missed diagnosis rate were 93.75%, 93.75% and 6.25%, respectively. There were 2 cases of bleeding complications >5 mL after C-TBNA, and both were resolved with endobronchial management. Conclusions: The combination of R-EBUS with C-TBNA was advantageous and safe for the diagnosis of solitary peribronchial pulmonary lesions located in the segmental bronchi. However, possible bleeding complications should be anticipated with needle aspiration. Further verification of this combined application should be investigated in larger clinical trials.

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DO - 10.7150/jca.28755

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JF - Journal of Cancer

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