PT  - JOURNAL ARTICLE
AU  - Adrian Chan
AU  - Anantham Devanand
AU  - Mariko Koh
TI  - Use of radial endobronchial ultrasound for diagnosing peripheral lung lesions - A tertiary centre experience
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - 1384
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/1384.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/1384.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Introduction:Small peripheral lung lesions continue to pose a diagnostic dilemma for pulmonologists. Flexible bronchoscopy with fluoroscopy has a limited diagnostic sensitivity (31-56%) for such lesions. Radial endobronchial ultrasound (EBUS) is a relatively new technique that has been used to improve yield, although diagnostic performance has been reported to vary considerably. We describe the characteristics of patients who underwent radial EBUS and outcomes in our centre.Methods:Retrospective review was performed for 123 patients from Singapore General Hospital with peripheral lung lesions who underwent brochoscopic evaluation with radial EBUS guidance from August 2008 to December 2011.Results:Median patient age was 64 years. Overall diagnostic yield was 68.3% with no difference for malignant (68.5%) or non-malignant (68%) lesions (p=0.954). Year-on-year diagnostic yield generally improved with increasing experience: in 2008, yield was 42.9% as compared to 2011 (80%). Data for ultrasound probe location was available for 93 patients. Yield was higher if the probe was within the lesion (78.3%) than when the probe was adjacent to the lesion (40%) (p=0.001). Data for lesion size was available for 118 patients. 40 patients had lesions less than 20mm diameter. Diagnostic yield of such lesions (77.5%) was higher than for larger lesions (64.1%), although this did not reach statistical significance (p=0.169).Conclusion:Radial EBUS is useful for evaluating peripheral lesions of less than 20mm diameter. Training and experience is important to improve diagnostic yield. We recommend that the ultrasound probe be positioned within the lesion before attempting bronchoscopic biopies.