Endoscopic ultrasound fine-needle aspiration by experienced pulmonologists: a cusum analysis

The European Respiratory Journal
Paul LeongDaniel P Steinfort

Abstract

Endobronchial ultrasound transbronchial needle aspiration (EBUS TBNA) is an established, minimally invasive way to sample intrathoracic abnormalities. The EBUS scope can be passed into the oesophagus to perform endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA). In cases of suspected lung cancer, a combination of the two techniques is now recommended by consensus guidelines. EBUS TBNA is usually performed by pulmonologists; however, the learning curve for EUS-B-FNA, which may be performed during the same procedure, has not been described.A multicentre, observational Australian study, using prospectively collected data from three experienced pulmonologists was conducted. Cumulative sum (cusum) analysis was used to generate visual learning curves.A total of 152 target lesions were sampled in 137 patients, with an overall sensitivity for malignancy of 94.8%. The sensitivity for malignant lesions outside of the 2009 International Association for the Study of Lung Cancer lymph node map (largely intraparenchymal lesions) was 92.9%. All three operators were competent by conventional cusum criteria. There was one case of pneumothorax, and no episodes of mediastinitis or oesophageal perforation were observ...Continue Reading

References

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Dec 23, 2016·Journal of Bronchology & Interventional Pulmonology·Daniel P SteinfortBarton R Jennings

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Citations

Sep 30, 2019·Respiration; International Review of Thoracic Diseases·Ida Skovgaard ChristiansenPaul Frost Clementsen
Aug 15, 2019·Respiration; International Review of Thoracic Diseases·Shivanthan ShanthikumarDaniel P Steinfort

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