RT Journal Article SR Electronic T1 Endoscopic ultrasound fine-needle aspiration by experienced pulmonologists: a cusum analysis JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1701102 DO 10.1183/13993003.01102-2017 VO 50 IS 5 A1 Paul Leong A1 Sheetal Deshpande A1 Louis B. Irving A1 Philip G. Bardin A1 Michael W. Farmer A1 Barton R. Jennings A1 Daniel P. Steinfort YR 2017 UL http://erj.ersjournals.com/content/50/5/1701102.abstract AB Endobronchial ultrasound transbronchial needle aspiration (EBUS TBNA) is an established, minimally invasive way to sample intrathoracic abnormalities. The EBUS scope can be passed into the oesophagus to perform endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA). In cases of suspected lung cancer, a combination of the two techniques is now recommended by consensus guidelines. EBUS TBNA is usually performed by pulmonologists; however, the learning curve for EUS-B-FNA, which may be performed during the same procedure, has not been described.A multicentre, observational Australian study, using prospectively collected data from three experienced pulmonologists was conducted. Cumulative sum (cusum) analysis was used to generate visual learning curves.A total of 152 target lesions were sampled in 137 patients, with an overall sensitivity for malignancy of 94.8%. The sensitivity for malignant lesions outside of the 2009 International Association for the Study of Lung Cancer lymph node map (largely intraparenchymal lesions) was 92.9%. All three operators were competent by conventional cusum criteria. There was one case of pneumothorax, and no episodes of mediastinitis or oesophageal perforation were observed.Our data suggest that experienced pulmonologists can safely and accurately perform EUS-B-FNA, with a high diagnostic sensitivity for both lymph node and non-nodal lesions.Endoscopic ultrasound fine-needle aspiration can be performed with an endobronchial scope http://ow.ly/LtPd30fwkn1