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Editorials |

The Mounting Evidence for Endobronchial Ultrasound

Gerard A. Silvestri, MD, FCCP
Author and Funding Information

Gerard A. Silvestri, MD, FCCP, Medical University of South Carolina, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, 171 Ashley Ave, Room 812-CSB, Charleston, SC 29425-2220; e-mail: silvestri@musc.edu

Dr. Silvestri is Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina.


Dr. Silvestri has received grants from Olympus America and the National Cancer Institute, holds shares in Alveolus, and consults for MGI Pharma, Inc. He is on the speakers bureau of Olympus America, Alveolus, and MGI Pharma, Inc.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(2):327-328. doi:10.1378/chest.09-0601
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Extract

At the 2008 Annual Meeting of the American College of Chest Physicians, I was asked to debate the usefulness of endobronchial ultrasound (EBUS) with fine-needle aspiration (FNA) compared to standard blind transbronchial needle aspiration (TBNA) for evaluating mediastinal adenopathy. I was given the pro EBUS-FNA position. I thought I was awarded the easier assignment. My opponent had the problematic task of defending a technology with a spotty track record at best. I felt that I mounted a vigorous assault on TBNA based on clinical data when it was available, and clinical logic when it was not. At the end of the debate, like all who are passionate in what they believe, I clearly thought that the weight of the evidence heavily favored EBUS. The moderator asked for the audience to settle the score via a show of hands. With > 150 people in attendance, only three hands arose on behalf of EBUS-FNA. After crawling back to my hotel to digest this stunning defeat, I again reviewed the literature on this topic and tried to determine whether I was truly wrong or had failed to adequately articulate my position. Perhaps in writing this editorial I can better convey the case for EBUS.

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