Rapid on-site evaluation of touch imprints of biopsies improves the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy: a retrospective study

2021 ◽  
Author(s):  
Hansheng Wang ◽  
Tao Ren ◽  
Xiao Wang ◽  
Na Wei ◽  
Guoshi Luo ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Transbronchial Biopsy ◽  
Transbronchial Needle Aspiration ◽  
Forceps Biopsy ◽  
Significant Difference ◽  
Evaluation Group ◽  
Site Evaluation ◽  
High Level

Abstract Objective Rapid on-site evaluation has long been used for transbronchial needle aspiration or fine-needle aspiration to evaluate the adequacy of biopsy materials for the diagnosis of peripheral lung lesions. However, research on rapid on-site evaluation combined with transbronchial forceps biopsy in the diagnosis of lung carcinoma is rarely reported. Therefore, we aimed to investigate the value of rapid on-site evaluation during transbronchial forceps biopsy for endoscopically visible (tumor, infiltrative and necrotic) or nonvisible (compressive, nonspecific and normal) malignancy. Methods A retrospective analysis was performed between January 2015 and January 2019 in Taihe Hospital with 1216 lung cancer patients who underwent bronchoscopy procedures, and these patients were allocated into the rapid on-site evaluation group and non-rapid on-site evaluation group, depending on the timing of the procedure. According to endoscopic features, bronchoscopic appearance was described as endoscopically visible malignancy (tumor, infiltrative and necrotic) and endoscopically nonvisible malignancy (compressive, nonspecific and normal). The diagnostic yield was compared, and the concordance between the rapid on-site evaluation results and the final histology was analyzed. Results There was a statistically significant difference in the diagnostic yield between the rapid on-site evaluation and non-rapid on-site evaluation groups for endoscopically nonvisible malignancy (74.3% vs. 51.7%, P < 0.05). However, we found no significant improvement in terms of diagnostic yield for endoscopically visible malignancy (95.2% vs. 91.2%, P > 0.05). The rapid on-site evaluation results showed high-level concordance with histology in the diagnosis of squamous cell carcinoma, adenocarcinoma and small cell carcinoma, with kappa values of 0.749 (P < 0.05), 0.728 (P < 0.05) and 0.940 (P < 0.05), respectively. Conclusions The findings demonstrated that the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy (compressive, nonspecific and normal) was significantly improved when rapid on-site evaluation was implemented. In addition, the rapid on-site evaluation results had high-level concordance with the final histological diagnosis.

scholarly journals Transbronchial needle aspiration in peripheral pulmonary lesions: a systematic review and meta-analysis

2016 ◽  
Vol 48 (1) ◽  
pp. 196-204 ◽  
Author(s):  
Michele Mondoni ◽  
Giovanni Sotgiu ◽  
Martina Bonifazi ◽  
Simone Dore ◽  
Elena Maria Parazzini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Sampling Technique ◽  
Needle Aspiration ◽  
Lesion Size ◽  
Transbronchial Needle Aspiration ◽  
Pulmonary Lesions ◽  
Site Evaluation ◽  
Peripheral Pulmonary Lesions

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 0.44–0.61). TBNA showed a higher accuracy when directly compared to TBB (0.60 (95% CI 0.49–0.71) versus 0.45 (95% CI 0.37–0.54)). The subgroup analyses documented a higher TBNA yield when the computed tomography (CT) bronchus sign was present (0.70 (95% CI 0.63–0.77) versus 0.51 (95% CI 0.38–0.64)), when rapid on-site evaluation (ROSE) was performed (0.62 (95% CI 0.43–0.79) versus 0.51 (95% CI 0.42–0.60)), in the case of malignant lesions (0.55 (95% CI 0.44–0.66) versus 0.17 (95% CI 0.11–0.24)) and for lesions >3 cm (0.81 (95% CI 0.73–0.87) versus 0.55 (95% CI 0.47–0.63)).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.

scholarly journals Utility of on-site evaluation of endobronchial ultrasound-guided transbronchial needle aspiration specimens

CytoJournal ◽  
2011 ◽  
Vol 8 ◽  
pp. 20 ◽  
Author(s):  
Adrienne Carruth Griffin ◽  
Lauren Ende Schwartz ◽  
Zubair W. Baloch
Keyword(s):  
Clinical Decision Making ◽  
Malignant Tumors ◽  
Diagnostic Yield ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Cytologic Diagnosis ◽  
Transbronchial Needle Aspiration ◽  
Site Evaluation

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an integral tool in the diagnosis and staging of malignant tumors of the lung. Rapid on-site evaluation (ROSE) of fine needle aspiration (FNA) samples has been advocated for as a guide for assessing the accuracy and adequacy of biopsy samples. Although ROSE has proven useful for numerous sites and procedures, few studies have specifically investigated its utility in the assessment of EBUS-TBNA specimens. The intention of this study was to explore the utility of ROSE for EBUS-TBNA specimens. Materials and Methods: The pathology files at our institution were searched for all EBUS-TBNA cases performed between January 2010 and June 2010. The data points included number of sites sampled per patient, location of site(s) sampled, on-site evaluation performed, preliminary on-site diagnosis rendered, final cytologic diagnosis, surgical pathology follow-up, cell blocks, and ancillary studies performed. Results: A total of 294 EBUS-TBNA specimens were reviewed and included in the study; 264 of 294 (90%) were lymph nodes and 30 of 294 (10%) were lung mass lesions. ROSE was performed for 140 of 294 (48%) specimens. The on-site and final diagnoses were concordant in 104 (74%) and discordant in 36 (26%) cases. Diagnostic specimens were obtained in 132 of 140 (94%) cases with on-site evaluation and 138 of 154 (90%) without on-site evaluation. The final cytologic diagnosis was malignant in 60 of 132 (45%) cases with ROSE and 46 of 138 (33%) cases without ROSE, and the final diagnosis was benign in 57 of 132 (47%) with ROSE and 82 of 138 (59%) without ROSE. A cell block was obtained in 129 of 140 (92%) cases with ROSE and 136 of 154 (88%) cases without ROSE. Conclusions: The data demonstrate no remarkable difference in diagnostic yield, the number of sites sampled per patient, or clinical decision making between specimens collected via EBUS-TBNA with or without ROSE. As a result, this study challenges the notion that ROSE is beneficial for the evaluation of EBUS-TBNA specimens.

scholarly journals Diagnostic yield of rapid on-site evaluation transbronchial needle aspiration versus conventional transbronchial needle aspiration: a single center experience

2020 ◽  
Vol 90 (1) ◽  
Author(s):  
Carmine Guarino ◽  
Mariano Mollica ◽  
Cristiano Cesaro ◽  
Adriano Costigliola ◽  
Maria Carolina Micheli ◽  
...  
Keyword(s):  
Lymph Node ◽  
Diagnostic Yield ◽  
Mediastinal Lymph Node ◽  
Diagnostic Testing ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Lymph Node Involvement ◽  
Transbronchial Needle Aspiration ◽  
Single Center Experience ◽  
Site Evaluation

Trans-bronchial needle aspiration allows lymph node sampling in several thoracic conditions; the ability of Rapid On-Site Evaluation (ROSE) to predict the final diagnosis in this setting has not been well characterized. We performed a retrospective study to establish the utility of ROSE in the diagnosis of thoracic diseases with mediastinal lymph node involvement. We retrospectively reviewed 297 patients with hilar-mediastinal lymph node enlargement detected at CT scan from January 2013 to April 2016. 201 patients underwent conventional TBNA; in 96 patients, TBNA procedure was performed by on-site presence of a team of pathologists and research morphologists. Lung neoplasms, sarcoidosis, infections and lymphoma were the most common diseases diagnosed with TBNA samples. TBNA simultaneously performed in combination with ROSE produced an increase in percentage of appropriate samples compared to single cTBNA (adequate samples cTBNA vs ROSE-TBNA: 73% vs 81%; p<0.05). Our observations indicate an increase in adequacy of fine needle aspirations and increased diagnostic yield in the ROSE group. In conclusions, ROSE may serve to reduce procedure time and enhance sample triaging therefore limiting the need for further invasive diagnostic testing.

Diagnostic yield of conventional transbronchial needle aspiration in suspected bronchogenic carcinoma without intraluminal growth on bronchoscopy

2017 ◽  
Vol 5 (4) ◽  
pp. 1270 ◽  
Author(s):  
Davis Kizhakkepeedika Rennis ◽  
Easwaramangalath Venugopal Krishnakumar ◽  
Navmi Sankarapotti
Keyword(s):  
Bronchogenic Carcinoma ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Transbronchial Needle Aspiration ◽  
Ct Guided ◽  
Forceps Biopsy ◽  
Bronchial Washing ◽  
Intraluminal Mass

Background: Bronchogenic carcinoma with spread along the mucosal plane presents as an exophytic mass. Most of the submucosal and peribronchial patterns of this malignancy are harder to detect by standard diagnostic procedures such as bronchial washing, brushing and forceps biopsy. We sought to investigate the utility of transbronchial needle aspiration (TBNA) in the diagnosis of bronchogenic carcinoma without intraluminal mass, through prospective analysis of routine diagnostic bronchoscopies performed in a 24-month period, at a tertiary care hospital.Methods: Patients with suspected bronchogenic carcinoma (clinical and radiological) underwent standard computed tomography (CT) of thorax. Further the patients were subjected to conventional TBNA, singly, and in combination with bronchial washings and brushings. The results were analyzed statistically for the diagnostic yield of TBNA.Results: Among the 42 patients assessed, 29 had malignancy confirmed by forceps biopsy or CT guided Fine Needle aspiration cytology or biopsy and bronchoscopy. Among them, 17 cases were detected by a combination of the results of bronchial washing, brushing and TBNA. The individual sensitivities amounted to 3.4% (n=1), 51.72% (n=15) and 27.6% (n=8), respectively. There were no false positive results. Concerning different bronchoscopic sampling techniques, 9 cases were diagnosed solely by bronchial brushings and 2 cases by TBNA alone. No periprocedural complications were encountered.Conclusions: Value of bronchial brushing in the diagnosis of bronchogenic carcinoma without bronchoscopically visible intraluminal mass is above that of conventional TBNA. Addition of bronchial washings, to bronchial brushings and TBNA has an insignificant impact on the diagnosis.

scholarly journals Transbronchial needle aspiration cytology of endobronchial abnormalities: does it increase the positivity rates of bronchoscopy

2014 ◽  
Vol 4 (7) ◽  
pp. 565-569
Author(s):  
B Thapa ◽  
R Sapkota ◽  
KR Shrestha ◽  
P Sayami ◽  
G Sayami
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Diagnostic Yield ◽  
Sampling Technique ◽  
Needle Aspiration ◽  
Small Cell ◽  
Sampling Techniques ◽  
Transbronchial Needle Aspiration ◽  
Negative Results ◽  
Diagnosis Of Lung Cancer

Background: Negative results in bronchoscopic sampling techniques increase costs and delay treatment. We analyzed if addition of transbronchial needle aspiration (TBNA) increases the diagnostic yield of bronchoscopy. Materials and Methods: Patients with endobronchial abnormalities in whom a full set of sampling techniques (lavage, TBNA, biopsy and brushing) were done and had a confirmed diagnosis of lung cancer by one or more methods were included. The positivity rates of each of the sampling techniques and their various combinations were studied. We compared the positivity rates of bronchoscopy with and without TBNA. We also studied if TBNA was more valuable in any specific type, histology or position of endobronchial abnormalities. Results: The overall positivity rate of TBNA was 56%. It was higher than lavage and brushing but lower than biopsy. The addition of TBNA to the routine combination of sampling tachniques (lavage, biopsy and brushing) increased diagnostic yield from 76% to 86.6%. Contrary to previous reports, the increase in diagnostic yields did not differ significantly between types (exophytic vs submucosal), side or location of the endobronchial lesions. TBNA was found to have a significantly better positivity rates in small cell carcinoma than in non-small cell carcinoma cases. Conclusion: TBNA is a safe sampling technique for endobronchial abnormalities during bronchoscopy. It increases the diagnostic yields of bronchoscopy and this increase seems to be uniform amongst different types, histologies and locations of endobronchial abnormalities. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10324 Journal of Pathology of Nepal (2014) Vol. 4, 565-569

scholarly journals Diagnostic Utility of Transbronchial Needle Aspiration in Malignant Endobronchial Lesions: Relevance to Lesions’ Characteristics

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Sherif A. A. Mohamed ◽  
Yousef Ahmed ◽  
Khaled Hussein ◽  
Nashwa M. A. Abd El-Aziz ◽  
Yasser Gamal
Keyword(s):  
Prospective Study ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Diagnostic Techniques ◽  
Diagnostic Utility ◽  
Transbronchial Needle Aspiration ◽  
Forceps Biopsy ◽  
Mass Lesions

In this prospective study, we aimed to report our experience with the diagnostic utility of transbronchial needle aspiration (TBNA) in patients with malignant endobronchial lesions detected during routine bronchoscopy. Ninety-four patients were enrolled. TBNA and conventional diagnostic techniques (CDTs: forceps biopsy, brushing, and washing) were performed in all patients. Endobronchial lesions were classified into exophytic mass lesions (EMLs), submucosal disease (SD), and peribronchial disease (PD). The diagnostic yields of TBNA and CDT alone and together were compared according to the lesions’ types, histopathology, and locations. During 3-year period, the addition of TBNA to CDT improved bronchoscopic sensitivity from 70.2% to 94.7% in all lesion types. Addition of TBNA to CDT increased the diagnostic success from 74% to 95% and from 50% to 94% in NSCLC and SCLC, respectively. The diagnostic success was increased in all localizations by the addition of TBNA to CDT, particularly for lesions located at the trachea, main bronchi, and upper lobes. We conclude that the addition of TBNA to CDT increases the diagnostic yield in patients with visible malignant endobronchial lesions, particularly in peribronchial disease, and improves the diagnostic yield of bronchoscopy, in both NSCLC and SCLC and in all bronchoscopic locations, particularly in central and upper lobar lesions.

scholarly journals Rapid On-Site Evaluation of Endobronchial Ultrasound–Guided Transbronchial Needle Aspirations for the Diagnosis of Lung Cancer: A Perspective From Members of the Pulmonary Pathology Society

2017 ◽  
Vol 142 (2) ◽  
pp. 253-262 ◽  
Author(s):  
Deepali Jain ◽  
Timothy Craig Allen ◽  
Dara L. Aisner ◽  
Mary Beth Beasley ◽  
Philip T. Cagle ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Current Status ◽  
Molecular Testing ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Site Evaluation ◽  
Diagnosis Of Lung Cancer

Context.— Endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a very useful tool in the field of diagnostic respiratory cytology. Rapid on-site evaluation (ROSE) of EBUS-TBNA not only has the potential to improve diagnostic yield of the procedure but also to triage samples for predictive molecular testing to guide personalized treatments for lung cancer. Objective.— To provide an overview of the current status of the literature regarding ROSE of EBUS-TBNA in the diagnosis of lung cancer. Data Sources.— An electronic literature search in PubMed and Google databases was performed using the following key words: cytology, lung cancer, on-site evaluation, rapid on-site evaluation, and ROSE EBUS-TBNA. Only articles published in English were included in this review. Conclusions.— Rapid on-site evaluation can ensure that the targeted lesion is being sampled and can enable appropriate specimen triage. If available, it should be used with EBUS-TBNA in the diagnosis of lung cancer because it can minimize repeat procedures for additional desired testing (ie, molecular studies). Some studies have shown that ROSE does not adversely affect the number of aspirations, total procedure time of EBUS-TBNA, or the rate of postprocedure complications; it is also helpful in providing a preliminary diagnosis that can reduce the number of additional invasive procedures, such as mediastinoscopy. As EBUS technology continues to evolve, our knowledge of the role of ROSE in EBUS-TBNA for the diagnosis of lung cancer will also continue to grow and evolve.

scholarly journals Diagnostic yield of TBNA and bronchial biopsy in lung cancer

2017 ◽  
Vol 5 (8) ◽  
pp. 3708 ◽  
Author(s):  
Anita Kumari ◽  
Madhu Gupta ◽  
. Abhesheik
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Diagnostic Yield ◽  
Fiberoptic Bronchoscopy ◽  
Needle Aspiration ◽  
Bronchial Biopsy ◽  
Transbronchial Needle Aspiration ◽  
Incidence And Mortality

Background: Lung cancer has been the most common cancer worldwide since 1985, both in terms of incidence and mortality.  In India, approximately 63,000 new lung cancer cases are reported each year. The study was undertaken to detect diagnostic yield of bronchial biopsy and transbronchial needle aspiration in suspected cases of bronchogenic carcinoma.Methods: This was a prospective study including 57 patients having clinical and radiological features of malignancy. Endobronchial forceps biopsy (FB) and transbronchial needle aspiration cytology (TBNA) has been employed during fiber-optic bronchoscopy. The statistical analysis was done using chi-square test.Results: Out of total 57 patients, 43 were found malignant on FB plus TBNA. The majority of patients (59.45%) were found to have squamous cell carcinoma on biopsy followed by Adenocarcinoma (16.21%), Small cell carcinoma (13.51%) and untypable cases (10.81%). On TBNA majority of patients (41.93%) could not be typed into any of the specific subtype. Out of rest typable carcinoma majority were squamous cell carcinoma (35.48%). Sensitivity of TBNA in diagnosing lung malignancy was 67.6%. The yield of TBNA, FB and TBNA plus FB was 54.38%, 64.91% and 75.43% respectively. Additional yield of TBNA over FB was 10.52%.Conclusions: TBNA is a beneficial, safe and minimally invasive bronchoscopic technique and may be considered routinely during Fiberoptic Bronchoscopy procedure to increase the yield with insignificant side effects in the diagnosis of bronchogenic carcinoma.

scholarly journals Diagnostic utility of conventional transbronchial needle aspiration without rapid on-site evaluation in patients with lung cancer

Lung India ◽  
2014 ◽  
Vol 31 (3) ◽  
pp. 208 ◽  
Author(s):  
Karan Madan ◽  
Anant Mohan ◽  
Deepali Jain ◽  
Vijay Hadda ◽  
GopiC Khilnani ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Needle Aspiration ◽  
Diagnostic Utility ◽  
Transbronchial Needle Aspiration ◽  
Site Evaluation
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