Transbronchial needle aspiration: where are we now?

Abstract

Lung cancer, as the leading cause of cancer-related motility and mortality worldwide, usually ends up with poor prognosis, despite abundant progress of therapeutic approaches. Early diagnosis and staging is extremely critical and directly affects clinical managements and outcomes. Transbronchial needle aspiration (TBNA), serving as an effective tool, has been widely used for mediastinal and hilar lung cancer staging. Recent advance in bronchoscopy introduces ultrasound probe to regular bronchoscope, resulting in TBNA procedures real-time visualized. Here, we summarize the advantages and disadvantages of conventional TBNA (cTBNA) and ultrasound-guided TBNA by comparing the instruments, methodology as well as the anatomy. We believe these two techniques are not competitive but complementary, judging the indications of patients for different technique would be a raising issue applied for pulmonologists.

Keywords: EBUS; Transbronchial needle aspiration (TBNA); esophageal ultrasound-guided fine needle aspiration (TENA); lung cancer; percutaneous needle aspiration (PCNA); staging.

Figure 1

Eleven lymph node stations in Wang’s map: (A) endoscopic view, (B) correlated CT view and (C) relevant puncture site.

Video 1

The use of MW-319 needle in a EUS-bronchoscopy.