@article {Mondoni196, author = {Michele Mondoni and Giovanni Sotgiu and Martina Bonifazi and Simone Dore and Elena Maria Parazzini and Paolo Carlucci and Stefano Gasparini and Stefano Centanni}, title = {Transbronchial needle aspiration in peripheral pulmonary lesions: a systematic review and meta-analysis}, volume = {48}, number = {1}, pages = {196--204}, year = {2016}, doi = {10.1183/13993003.00051-2016}, publisher = {European Respiratory Society}, abstract = {Fluoroscopy-guided transbronchial needle aspiration (TBNA) has long been used in the diagnosis of peripheral pulmonary lesions (PPLs), although its diagnostic performance varies considerably.We conducted a systematic review and meta-analysis evaluating the accuracy of TBNA in the diagnosis of PPLs, comparing its diagnostic yield with transbronchial biopsy (TBB) and assessing the main predictors of a successful aspirate.In 18 studies, the overall TBNA yield was 0.53 (95\% CI 0.44{\textendash}0.61). TBNA showed a higher accuracy when directly compared to TBB (0.60 (95\% CI 0.49{\textendash}0.71) versus 0.45 (95\% CI 0.37{\textendash}0.54)). The subgroup analyses documented a higher TBNA yield when the computed tomography (CT) bronchus sign was present (0.70 (95\% CI 0.63{\textendash}0.77) versus 0.51 (95\% CI 0.38{\textendash}0.64)), when rapid on-site evaluation (ROSE) was performed (0.62 (95\% CI 0.43{\textendash}0.79) versus 0.51 (95\% CI 0.42{\textendash}0.60)), in the case of malignant lesions (0.55 (95\% CI 0.44{\textendash}0.66) versus 0.17 (95\% CI 0.11{\textendash}0.24)) and for lesions \>3 cm (0.81 (95\% CI 0.73{\textendash}0.87) versus 0.55 (95\% CI 0.47{\textendash}0.63)).Conventional TBNA is a useful sampling technique for the diagnosis of PPL, with a higher diagnostic yield than TBB. The presence of CT bronchus sign, an underlying malignant process, lesion size \>3 cm and ROSE employment are predictors of a higher yield.Fluoroscopy-guided transbronchial needle aspiration is a useful technique in diagnosing peripheral pulmonary lesions http://ow.ly/4mK0sB}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/48/1/196}, eprint = {https://erj.ersjournals.com/content/48/1/196.full.pdf}, journal = {European Respiratory Journal} }