Linear Endobronchial Ultrasound With a Lung Target: Analysis of the Stather Canadian Outcomes Registry for Chest Procedures (SCOPE).

Abstract

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure that allows for the evaluation of mediastinal and hilar lymph nodes. It has also been described in limited studies for the evaluation of central pulmonary lesions.

Objectives: Our study aimed to describe the diagnostic performance of linear EBUS in pulmonary lesions, the sensitivity for malignancy, and its suitability as an adjunctive test for lung cancer.

Methods: We analyzed procedures from the Stather Canadian Outcomes Registry for Chest Procedures (SCOPE) database that included sampling of at least 1 intrapulmonary lesion with linear EBUS. Diagnostic yield (DY) and sensitivity were calculated using the standard definitions. Suitability for molecular testing was evaluated in the lung cancer cohort, in which lung lesion sampling was the only diagnostic site.

Results: Four hundred and 10 records were identified, one of which was excluded for lack of follow-up data. The most frequent final diagnosis was lung cancer in 346/409 cases (84.6%). DY for the lung EBUS-TBNA was 370/409 (90.5%), and sensitivity for malignancy was 358/372 (96.2%). The sensitivity of linear EBUS lung TBNA for lung cancer was 331/346 (95.7%). The data set did not record failed attempts at lung lesion localization with linear EBUS, during which no sample was collected.

Conclusion: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an effective and safe diagnostic tool for lung lesions visible on ultrasound. Lesion size is associated with improved DY. Lung cancer ancillary testing is feasible in almost all cases.