Diagnosis and invasive staging: Non-surgical invasive mediastinal staging. Endobronchial ultrasound

Abstract

The diagnosis and staging of lung cancer are an important process that identifies treatment options and guides disease prognosis. Therefore, an accurate mediastinal lymph node (LN) staging is required not only to offer the appropriate treatment but also to avoid unnecessary invasive procedures. At present, endobronchial ultrasound (EBUS)-transbronchial needle aspiration is the preferred modality for sampling mediastinal lymph nodes because of its minimally invasive nature and high diagnostic yield. In this review, we discuss the utility of EBUS in mediastinal LN staging of non-small cell lung cancer (NSCLC).

Relevance for patients: The use of EBUS-TBNA in the diagnosis of mediastinal and hilar LN pathology has become in an essential endoscopic technique and the first step for staging of lung cancer.

Keywords: Endobronchial ultrasound; Endobronchial ultrasound-transbronchial needle aspiration; Lung cancer; Lung cancer staging.

Figure 1. Proposed mediastinal staging algorithm. Modified from Sánchez de Cos J et al. [6]. *Surgical techniques: mediastinoscopy, mediastinotomy, extended cervical mediastinoscopy, thoracoscopy, transcervical extended mediastinal lymphadenectomy, and video-assisted mediastinoscopic lymphadenectomy.

Figure 2. (A) Convex transducer of endobronchial ultrasound and transbronchial needle aspiration in the work channel. (B) Real-time of endobronchial ultrasound and the needle puncture of lymph node.