Fluoroscopy guided percutaneous biopsy in combination with bronchoscopy and endobronchial ultrasound in the diagnosis of suspicious lung lesions – the triple approach
Flexible bronchoscopy and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) are the pulmonologists´ basic procedures for the biopsy of suspicious lung lesions. If inconclusive, other guiding-modalities for tissue sampling are needed, computed tomography performed by a radi...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-01-01
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| Series: | European Clinical Respiratory Journal |
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| Online Access: | http://dx.doi.org/10.1080/20018525.2020.1723303 |
| _version_ | 1828783789291077632 |
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| author | Jatinder Singh Sidhu Geir Salte Ida Skovgaard Christiansen Therese Marie Henriette Naur Asbjørn Høegholm Paul Frost Clementsen Uffe Bodtger |
| author_facet | Jatinder Singh Sidhu Geir Salte Ida Skovgaard Christiansen Therese Marie Henriette Naur Asbjørn Høegholm Paul Frost Clementsen Uffe Bodtger |
| author_sort | Jatinder Singh Sidhu |
| collection | DOAJ |
| description | Flexible bronchoscopy and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) are the pulmonologists´ basic procedures for the biopsy of suspicious lung lesions. If inconclusive, other guiding-modalities for tissue sampling are needed, computed tomography performed by a radiologist, or – if available – radial EBUS or electromagnetic navigation biopsy. We wanted to investigate if same-day X-ray fluoroscopy-guided transthoracic fine-needle aspiration biopsy (F-TTNAB) performed by the pulmonologist immediately after bronchoscopy and EBUS is a feasible alternative. We retrospectively identified consecutive patients in whom F-TTNAB followed a bronchoscopy and EBUS in the same séance. Patients in whom the suspicion of malignancy was invalidated after complete work up were followed for six months to identify false-negative cases. In total 125 patients underwent triple approach (bronchoscopy, EBUS and F-TTNAB) during the same séance. Malignancy was diagnosed in 86 (69%), and 77 of these (90%) were primary lung cancers. The diagnostic yield of F-TTNAB for malignancy was 77%, and sensitivity was 90%. Pneumothorax occurred in 35 (28%) patients, and was administered with pleural drainage in 22 (18% of all patients). No cases of prolonged haemoptysis were observed. The risk of pneumothorax differed insignificantly with lesion size ≤2.0 cm (27%) versus >2.0 cm (29%). We conclude that it is feasible for pulmonologist to perform F-TTNAB immediately after endoscopy as a combined triple approach in a fast-track workup of suspected lung cancer. |
| first_indexed | 2024-12-11T23:18:42Z |
| format | Article |
| id | doaj.art-a4606ef032044ef2abf6a0a985ce4751 |
| institution | Directory Open Access Journal |
| issn | 2001-8525 |
| language | English |
| last_indexed | 2024-12-11T23:18:42Z |
| publishDate | 2020-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Clinical Respiratory Journal |
| spelling | doaj.art-a4606ef032044ef2abf6a0a985ce47512022-12-22T00:46:25ZengTaylor & Francis GroupEuropean Clinical Respiratory Journal2001-85252020-01-017110.1080/20018525.2020.17233031723303Fluoroscopy guided percutaneous biopsy in combination with bronchoscopy and endobronchial ultrasound in the diagnosis of suspicious lung lesions – the triple approachJatinder Singh Sidhu0Geir Salte1Ida Skovgaard Christiansen2Therese Marie Henriette Naur3Asbjørn Høegholm4Paul Frost Clementsen5Uffe Bodtger6Naestved HospitalNaestved HospitalNaestved HospitalUniversity of Copenhagen and the Capital Region of DenmarkNaestved HospitalZealand University HospitalNaestved HospitalFlexible bronchoscopy and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) are the pulmonologists´ basic procedures for the biopsy of suspicious lung lesions. If inconclusive, other guiding-modalities for tissue sampling are needed, computed tomography performed by a radiologist, or – if available – radial EBUS or electromagnetic navigation biopsy. We wanted to investigate if same-day X-ray fluoroscopy-guided transthoracic fine-needle aspiration biopsy (F-TTNAB) performed by the pulmonologist immediately after bronchoscopy and EBUS is a feasible alternative. We retrospectively identified consecutive patients in whom F-TTNAB followed a bronchoscopy and EBUS in the same séance. Patients in whom the suspicion of malignancy was invalidated after complete work up were followed for six months to identify false-negative cases. In total 125 patients underwent triple approach (bronchoscopy, EBUS and F-TTNAB) during the same séance. Malignancy was diagnosed in 86 (69%), and 77 of these (90%) were primary lung cancers. The diagnostic yield of F-TTNAB for malignancy was 77%, and sensitivity was 90%. Pneumothorax occurred in 35 (28%) patients, and was administered with pleural drainage in 22 (18% of all patients). No cases of prolonged haemoptysis were observed. The risk of pneumothorax differed insignificantly with lesion size ≤2.0 cm (27%) versus >2.0 cm (29%). We conclude that it is feasible for pulmonologist to perform F-TTNAB immediately after endoscopy as a combined triple approach in a fast-track workup of suspected lung cancer.http://dx.doi.org/10.1080/20018525.2020.1723303lung cancerebusflouroscopy guidedttnabtransthoracic needle aspirationflouroscopy guided ttnabendobronchial ultrasound |
| spellingShingle | Jatinder Singh Sidhu Geir Salte Ida Skovgaard Christiansen Therese Marie Henriette Naur Asbjørn Høegholm Paul Frost Clementsen Uffe Bodtger Fluoroscopy guided percutaneous biopsy in combination with bronchoscopy and endobronchial ultrasound in the diagnosis of suspicious lung lesions – the triple approach European Clinical Respiratory Journal lung cancer ebus flouroscopy guided ttnab transthoracic needle aspiration flouroscopy guided ttnab endobronchial ultrasound |
| title | Fluoroscopy guided percutaneous biopsy in combination with bronchoscopy and endobronchial ultrasound in the diagnosis of suspicious lung lesions – the triple approach |
| title_full | Fluoroscopy guided percutaneous biopsy in combination with bronchoscopy and endobronchial ultrasound in the diagnosis of suspicious lung lesions – the triple approach |
| title_fullStr | Fluoroscopy guided percutaneous biopsy in combination with bronchoscopy and endobronchial ultrasound in the diagnosis of suspicious lung lesions – the triple approach |
| title_full_unstemmed | Fluoroscopy guided percutaneous biopsy in combination with bronchoscopy and endobronchial ultrasound in the diagnosis of suspicious lung lesions – the triple approach |
| title_short | Fluoroscopy guided percutaneous biopsy in combination with bronchoscopy and endobronchial ultrasound in the diagnosis of suspicious lung lesions – the triple approach |
| title_sort | fluoroscopy guided percutaneous biopsy in combination with bronchoscopy and endobronchial ultrasound in the diagnosis of suspicious lung lesions the triple approach |
| topic | lung cancer ebus flouroscopy guided ttnab transthoracic needle aspiration flouroscopy guided ttnab endobronchial ultrasound |
| url | http://dx.doi.org/10.1080/20018525.2020.1723303 |
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