Pulmonary Procedures |

Radial Probe Endobronchial Ultrasound for Peripheral Pulmonary Nodules: Five Years and Five Hundred Cases FREE TO VIEW

Alexander Chen, MD; Praveen Chenna, MD; Andrea Loiselle, MD; Jennifer Massoni, NP-C; David Misselhorn, RRT
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Washington University School of Medicine, Saint Louis, MO

Chest. 2013;144(4_MeetingAbstracts):821A. doi:10.1378/chest.1704370
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SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 27, 2013 at 04:15 PM - 05:15 PM

PURPOSE: The detection of peripheral pulmonary nodules is increasing and will likely continue to increase with lung cancer screening for high risk patients forthcoming. Radial probe endobronchial ultrasound (EBUS) has been available for a decade, though remains highly underutilized as a tool for peripheral bronchoscopy. We report five years of experience using radial probe EBUS in nearly 500 cases at a tertiary care university hospital.

METHODS: Following approval by the Institutional Review Board (#201301002), peripheral bronchoscopy cases utilizing radial probe EBUS performed between January 1, 2008 and December 31, 2012 were reviewed retrospectively. Cases in which radial EBUS was used to assist with placement of fiducial markers, as well as cases which combined the use of radial EBUS with electromagnetic navigation were excluded. Nodules were classified by size: 1-2cm, 2.1-3cm, 3.1-4cm, 4.1-5cm and >5.1cm.

RESULTS: 496 cases of peripheral bronchoscopy for pulmonary nodules were screened, of which 467 cases used only radial probe EBUS for diagnostic purposes. A diagnosis was obtained in 321 patients (69%). By size, a diagnosis was obtained in 83/144 (58%) of nodules 1-2cm, 99/137 (72%) of nodules 2.1-3cm, 54/70 (77%) of nodules 3.1-4cm, 41/47 (87%) of nodules 4.1-5cm and 35/40 (88%) of nodules larger than 5.1cm. Of 467 total nodules, 21 (4%) could not be identified using radial probe EBUS.

CONCLUSIONS: Radial probe endobronchial ultrasound can be used successfully to guide biopsy during peripheral bronchoscopy. This technique provides real-time ultrasound based confirmation of target lesion localization. Using radial probe EBUS, the vast majority of peripheral pulmonary nodules can be identified.

CLINICAL IMPLICATIONS: Radial probe endobronchial ultrasound can assist the bronchoscopist with identifying peripheral pulmonary nodules, and may significantly increase the diagnostic yield of biopsy over conventional methods.

DISCLOSURE: Alexander Chen: Consultant fee, speaker bureau, advisory committee, etc.: Advisory committee The following authors have nothing to disclose: Praveen Chenna, Andrea Loiselle, Jennifer Massoni, David Misselhorn

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