PURPOSE: Endobronchial ultrasonography (EBUS) with a radial scanning probe provides cross-sectional images of peripheral pulmonary lesions. We devised two types of the EBUS probe and the guide sheath(thick probe and thin guide sheath, thin probe and thin guide sheath) for the diagnosis of peripheral pulmonary lesions.
METHODS: In the procedure of EBUS-GS, the probe covered by a guide sheath is introduced into the lesion via the working channel of a bronchoscope. The probe is withdrawn, while the guide sheath is left in situ. A brush or biopsy forceps is introduced through the guide sheath into the lesion. We compared diagnostic yields of two types of EBUS-GS.1st method (EBUS-thick GS): the thick ultrasonic probe (UM-20-20R, radial OLYMPUS) with a thick guide sheath (2.5 mm in diameter), and 150 lesions were evaluated.2nd method (EBUS-thin GS): the thin ultrasonic probe (XUM-20-17R, radial OLYMPUS) with a thin guide sheath (2.0 mm in diameter), and 130 lesions were evaluated.
RESULTS: 1st method : EBUS with the thick probe visualized the lesion in 140 lesions (93%) of 150 lesions. One hundred One hundred sixteen (77%) of 150 EBUS-GS procedures were diagnostic. Lesions which the probe was located within, had a significantly higher diagnostic yield (105/121, 87%) than that which the probe was located adjacent to (8/19, 42%). 2nd method: EBUS with the thin probe visualized the lesion in 128 lesions (97%) of 130 lesions. Diagnostic yield was 83% with the thinner guide sheath. Lesions which the probe was located within, had a significantly higher diagnostic yield (91/99, 92%) than that which the probe was located adjacent to (18/29, 62%). The diagnostic yield at left B1+2 with thin GS (88%) was higher than the diagnostic yield at left B1+2 that with thick GS (40%).
CONCLUSION: EBUS using the thin GS increase the yield of visualization by EBUS, and the diagnostic yield of lesions of left S1+2 .
CLINICAL IMPLICATIONS: EBUS using the thin GS will be one of the techniques of collecting specimens from the peripheral pulmonary lesion.
DISCLOSURE: Noriaki Kurimoto, No Financial Disclosure Information; No Product/Research Disclosure Information