Abstract
Introduction: Endobronchial ultrasound (EBUS) is a minimally invasive technique that expands the view of the bronchoscopist beyond the lumen of the airway. Radial probe EBUS (rEBUS) is used for the detection of peripheral lung lesions.
Aim: To analyze the diagnostic yield of rEBUS in peripheral pulmonary lesions.
Methods: All patients which underwent bronchoscopy to study peripheral lung lesions from January 2009 to February 2011 were prospectively included. Patients were randomly distributed in two groups: fluoroscopy and rEBUS (30 patients, 70.4±7.8 years) or fluoroscopy alone (64 patients, 68.1±10.9 years). All procedures were performed under fluoroscopic guidance with iv conscious sedation. rEBUS was performed using an endoscopic ultrasound system (EU-M60, Olympus, Tokyo, Japan), equipped with a 20-MHz mechanical radial type miniature probe (UM-BS S20-17S). Bronchoscopist, cytologist, study protocol, techniques and tools were the same ones throughout the whole study.
Results: 94 patients (68.9±10 years) with peripheral pulmonary lesions suspicious of malignancy were studied. The average size of these lesions was 35.2±13.6 mm in rEBUS group vs 41.8±19.6 mm in fluoroscopy group (n.s). In 26 cases (27.6%) the size was <30 mm: 7 cases (23%) in rEBUS group vs 19 (29%) in fluoroscopy group (n.s). Global diagnostic yield was 73% using rEBUS whereas it was 67% when using fluoroscopy alone (n.s.). Diagnostic yield in lesions <30 mm was higher in rEBUS (86% vs 58%, n.s.). No complications were reported related to rEBUS or iv sedation.
Conclusions: rEBUS is a promising, useful and safe technique for the diagnosis of peripheral pulmonary lesions, especially in those of small size.
- © 2011 ERS