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. 2022 Jan 31;13(4):1307-1312.
doi: 10.7150/jca.67113. eCollection 2022.

Radial Endobronchial Ultrasound for Lung Cancer Diagnosis: Tips and Tricks

Paul Zarogoulidis  1   2 , Haidong Huang  3 , Wei Chen  4 , Dimitris Petridis  5 , Dimitris Matthaios  6 , Wolfgang Hohenforst-Schmidt  7 , Christos Tolis  8 , Kosmas Tsakiridis  9 , Sofia Baka  10 , Christos Arnaoutoglou  11 , Maria Saroglou  12 , Stavros Tryfon  12 , Aris Ioannidis  13 , Lutz Freitag  14 , Christoforos Kosmidis  1 , Chong Bai  3
Affiliations

Radial Endobronchial Ultrasound for Lung Cancer Diagnosis: Tips and Tricks

Paul Zarogoulidis et al. J Cancer. .

Abstract

Introduction: Endoscopic techniques have been upgraded in the recent 10 years. We can use the radial endobronchial ultrasound to reach distal nodules in the periphery of the lungs, but also we can use it in order to make biopsies in lesions without endobronchial findings. Patients and Methods: We included in our study 248 patients with pulmonary nodules up to 4 cm. We use a radial endobronchial system from FUJI, a PENTAX bronchoscope and a C-ARM. We recorded the cancer type, biopsy method, time of each procedure, cell blocks and slices from cell blocks. Results: Two thirds of patients belonged to males (61.7%), forceps was the main tissue extraction technique (118, 47.6%) and tumors sized 1 to 2 cm were the most encountered (96, 38.7%). Samples with tissue content were present in 175 patients (70.6%) and one cell block dominated in the samples (109, 43.9%). Less than 20 minutes were needed to complete the operative procedure for the half patients (127, 51.2%), the C-Arm implementation concerned 117 persons (47.2%) and the majority of tumors was located in the central area of the lungs (178, 71.8%). Less time was necessary for central lesions and larger biopsy samples were acquired without the extensive use of C-ARM. Conclusion: The larger the nodule ≥2cm and in periphery the less we use the C-ARM and the time of the procedure is between 20-40 minutes. Moreover; we have more tissue sample and cell block slices.

Keywords: 22G needle; C-Arm; brush; elastography; forceps; lung cancer; metastasis; nsclc; radial ebus; sclc.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Left; endoscopic bronchoscopic image with the radial-ebus outside the bronchoscope, middle; image of the radial-ebus presenting a nodule, right; C-ARM image presenting the endoscope within the right bronchus.
Figure 2
Figure 2
During a procedure.
Figure 3
Figure 3
Age distribution of patients.
Figure 4
Figure 4
Numerical distribution of slices under study.
See this image and copyright information in PMC

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