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Pulmonology Procedures |

Comparison of Cytologic Accuracy of Endobronchial Ultrasound Transbronchial Needle Aspiration Using Needle Suction Versus No Suction

Kassem Harris*, MD; Rabih Maroun, MD; Michel Chalhoub, MD
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Staten Island University Hospital, Staten Island, NY


Chest. 2012;142(4_MeetingAbstracts):869A. doi:10.1378/chest.1390348
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Abstract

SESSION TYPE: Endobronchial Ultrasound

PRESENTED ON: Monday, October 22, 2012 at 04:00 PM - 05:30 PM

PURPOSE: To compare the diagnostic sensitivity and specificity of endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) while applying needle suction versus no suction.

METHODS: All adult subjects who were scheduled to undergo EBUS-TBNA to sample mediastinal lesions were eligible. We evaluated two methods of sampling mediastinal lesions. The first method was the application of negative pressure syringe for needle suction aspiration. The second was with no suction. For every patient, and every biopsy site in the same patient, we had two samples using each method.

RESULTS: Among the 26 participants, one of the patients (3.8%) had no adequate tissue using both methods; one patient (3.8%) had adequate tissue using suction but no adequate tissue using no suction; and 24 patients had adequate tissue using both methods (92.3%, p= 1.00). Among the twenty-four patients with adequate tissue using both methods, 14 patients (58.3%) had benign pathology using both methods, while ten patients (41.7%) had malignant pathology using both methods (p= 1.00). Considering suction to be the golden method, the sensitivity and specificity of no suction were 100%. Among the 32 sites that were sampled, one site (3.1%) had no adequate tissue using both methods; one site (3.1%) had adequate tissue using suction but no adequate tissue using no suction; and 30 sites had adequate tissue using both methods (93.8%, p= 1.00). Among the thirty sites with adequate tissue using both methods, 17 (56.7%) had benign pathology using both methods; 12 (40.0%) had malignant pathology using both methods; and one site (3.3%) had malignant pathology using suction, but benign pathology using no suction (p= 1.00). Considering suction to be the golden method, the no suction had a sensitivity= 92.3% and specificity= 100%.

CONCLUSIONS: In patients undergoing EBUS-TBNA to sample mediastinal lesions, the diagnostic yield with the application of suction to needle biopsy was not statistically significant compared to no suction.

CLINICAL IMPLICATIONS: EBUS-TBNA with or without suction is an appropriate procedure to sample mediastinal lesions.

DISCLOSURE: The following authors have nothing to disclose: Kassem Harris, Rabih Maroun, Michel Chalhoub

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Staten Island University Hospital, Staten Island, NY

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