Localization of Peripheral Pulmonary Lesions Using a Method of Computed Tomography-Anatomic Correlation and Radial Probe Endobronchial Ultrasound Confirmation.

Rationale: Peripheral pulmonary lesions requiring a diagnosis continue to present challenges to clinicians. One significant barrier is the inability to reliably locate peripheral lesions by bronchoscopic approaches. Multiplanar computed tomographic (CT) scan reconstruction is available to most physicians and provides axial, coronal, and sagittal images that may be used to estimate target lesion location and guide bronchoscopists during procedures.

Radial probe endobronchial ultrasound for peripheral pulmonary lesions. A 5-year institutional experience.

Rationale: Technological advances have improved the ability of bronchoscopists to access peripheral pulmonary lesions for tissue sampling. Radial probe endobronchial ultrasound (EBUS) provides real-time feedback to guide biopsies of peripheral lesions, thereby potentially improving diagnostic yield over conventional bronchoscopy.

Objectives: We assessed the overall diagnostic yield of peripheral bronchoscopy using radial probe EBUS for peripheral pulmonary lesions, as well as factors that might influence the diagnostic yield, such as radial ultrasound view, lesion size, and ability to locate the peripheral lesion.

Endobronchial-ultrasound guided miniforceps biopsy of mediastinal and hilar lesions.

Background: Linear array endobronchial ultrasound (EBUS) has greatly improved the diagnostic yield of transbronchial needle aspiration (TBNA) for the diagnosis of non-small cell lung carcinoma though its yield in granulomatous disease and lymphoproliferative disorders is less robust. The EBUS-miniforceps biopsy (MFB) uses miniforceps and the convex probe EBUS bronchoscope to obtain forceps biopsies of centrally located lesions under continuous ultrasound guidance. In this prospective study we evaluate the efficacy of this technique for diagnosing mediastinal and hilar abnormalities in patients with a low suspicion for non-small cell lung carcinoma.

Ultrasound-guided Transthoracic Forceps Biopsy of a Peripheral Lung Mass.

Interventional pulmonologists are often called upon to diagnose a variety of intrathoracic abnormalities. Linear array endobronchial ultrasound has greatly increased the diagnostic accuracy of transbronchial needle aspiration for centrally located lesions in the chest, and radial endobronchial ultrasound and electromagnetic navigation have markedly increased the diagnostic yield for biopsies of peripheral pulmonary lesions. Image-guided transthoracic biopsies of peripheral pulmonary lesions that approximate the pleural surface have been successfully performed using the "core" biopsy devices, though these may be less successful for smaller pleural-based lesions given their design.

Endobronchial Ultrasound-guided Transbronchial Miniforceps Biopsy of Mediastinal and Hilar Lymph Node Stations.

Linear array endobronchial ultrasound has significantly improved the diagnostic yield of transbronchial needle aspiration for the diagnosis of centrally located lesions within the thorax. Although transbronchial needle aspiration has become an accepted technique for diagnosing solid tumors within the chest, its yield for hematologic malignancies such as lymphoma and other benign conditions in which direct examination of tissue architecture are preferred is lower. Currently, surgical biopsies by mediastinoscopy or video-assisted thoracic surgery are often required to obtain adequate tissue specimens to make these diagnoses.

Biopsy of peripheral pulmonary lesions using real-time radial endobronchial ultrasound and a "double-barrel" bronchoscope.

Endobronchial ultrasound (EBUS) has contributed substantially to the diagnosis of centrally located lesions within the thorax. More recently, this technology has been applied to the diagnosis of peripheral pulmonary lesions. One accepted technique for visualizing peripheral pulmonary lesions using radial EBUS involves use of a guide sheath placed within or adjacent to the lesion after localization using a radial EBUS probe.