Endobronchial Ultrasound Guided Biopsy in Respiratory Disease-Real-time Endobronchial Ultrasound GuidedTransbronchial Needle Aspiration

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Endobronchial ultrasound (EBUS) guided biopsy in respiratory disease is a promising new modality. The radial probe EBUS has been used for the biopsy of peripheral lung lesions using the guide sheath. In addition, theradial probe EBUS guided TBNA has increased the yield of TBNA of mediastinal lymph nodes. However it is still not areal-time procedure with target visualization. To overcome these problems, a new convex probe endobronchial ultrasound (CP-EBUS) with ability to perform real-time EBUS guided TBNA (EBUS-TBNA) was developed. EBUS-TBNAcan be used for (a) lymph node staging in lung cancer patients; (b) diagnosis of intrapulmonary tumors; (c) diagnosisof unknown hilar and/or mediastinal lymphadenopathy; and (d) diagnosis of mediastinal tumors. A total of 161 procedures have been done using the CP-EBUS. In 98 patients with lung cancer or suspected lung cancer, EBUS-TBNA wasperformed to obtain samples from 121 lymph nodes. The sensitivity, specificity, and accuracy of EBUS-TBNA in distinguishing benign from malignant lymph nodes were 92.3%, 100%, and 93.9%, respectively. EBUS-TBNA of mediastinaltumors or mediastinal lymphadenopathy was successfully performed in 26 patients. The procedure was uneventful andthere were no complications. EBUS-TBNA is a novel approach that is safe and has a good diagnostic yield. This new ultrasound puncture bronchoscope has an excellent potential in assisting safe and accurate diagnostic interventionalbronchoscopy in respiratory diseases.