TY - JOUR
T1 - Diagnostic yield of endobronchial ultrasound and virtual CT navigational bronchoscopy for biopsy of pulmonary nodules, mediastinal lymph nodes, and thoracic tumors in children
AU - Corcoran, Aoife
AU - Franklin, Stephen
AU - Hysinger, Erik
AU - Goldfarb, Samuel
AU - Phinizy, Pelton
AU - Pogoriler, Jennifer
AU - Tran, Sin
AU - DiBardino, David M.
AU - Haas, Andrew R.
AU - Piccione, Joseph C.
N1 - Publisher Copyright:
© 2023 Wiley Periodicals LLC.
PY - 2024/2
Y1 - 2024/2
N2 - Objective: Endobronchial ultrasound-guided transbronchial biopsy and needle aspiration (EBUS-TBB/EBUS-TBNA) are first line investigative modalities for lung and mediastinal pathology in adults. We aimed to characterize and assess the diagnostic yield of EBUS and virtual CT navigation guided biopsies in children. Study Design: This single center, retrospective cohort study included patients who underwent radial or linear EBUS procedures (+/− CT navigation) for biopsy of mediastinal lymph nodes, tumors, and pulmonary nodules. Demographic, procedural, and outcome were collected. Results: Sixty procedures were performed in 56 patients aged 2–22 years of age between January 2015 and May 2023. The most common indications for biopsy were pulmonary nodules (45%) and hilar/mediastinal lymphadenopathy (33%). For cases in which a final diagnosis was ascertained by any means, the diagnostic yield for linear EBUS (mediastinal pathology) was 76% and the diagnostic yield from radial EBUS (pulmonary nodules and lung masses) was 85%. The most common diagnoses were infection (45%), malignancy (17%), and sarcoidosis (11%). Among patients in whom infection was the final diagnosis, a total of 31 pathogens were identified. Eighteen were identified on bronchoalveolar lavage and an additional 14 pathogens identified on EBUS-TBB, representing an increase of 77% (p <.005). The sensitivity, specificity, negative and positive predictive values for malignancy detection were 73%, 100%, 94%, and 100%, respectively. Conclusion: EBUS-TBB/TBNA is a safe and effective way to diagnose lung and mediastinal pathology in children. Pediatric interventional pulmonology is a growing field offering minimally-invasive diagnostic opportunities for children in whom more invasive procedures were previously the only option.
AB - Objective: Endobronchial ultrasound-guided transbronchial biopsy and needle aspiration (EBUS-TBB/EBUS-TBNA) are first line investigative modalities for lung and mediastinal pathology in adults. We aimed to characterize and assess the diagnostic yield of EBUS and virtual CT navigation guided biopsies in children. Study Design: This single center, retrospective cohort study included patients who underwent radial or linear EBUS procedures (+/− CT navigation) for biopsy of mediastinal lymph nodes, tumors, and pulmonary nodules. Demographic, procedural, and outcome were collected. Results: Sixty procedures were performed in 56 patients aged 2–22 years of age between January 2015 and May 2023. The most common indications for biopsy were pulmonary nodules (45%) and hilar/mediastinal lymphadenopathy (33%). For cases in which a final diagnosis was ascertained by any means, the diagnostic yield for linear EBUS (mediastinal pathology) was 76% and the diagnostic yield from radial EBUS (pulmonary nodules and lung masses) was 85%. The most common diagnoses were infection (45%), malignancy (17%), and sarcoidosis (11%). Among patients in whom infection was the final diagnosis, a total of 31 pathogens were identified. Eighteen were identified on bronchoalveolar lavage and an additional 14 pathogens identified on EBUS-TBB, representing an increase of 77% (p <.005). The sensitivity, specificity, negative and positive predictive values for malignancy detection were 73%, 100%, 94%, and 100%, respectively. Conclusion: EBUS-TBB/TBNA is a safe and effective way to diagnose lung and mediastinal pathology in children. Pediatric interventional pulmonology is a growing field offering minimally-invasive diagnostic opportunities for children in whom more invasive procedures were previously the only option.
KW - CT navigation bronchoscopy
KW - advanced bronchoscopy
KW - endobronchial ultrasound
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U2 - 10.1002/ppul.26756
DO - 10.1002/ppul.26756
M3 - Article
C2 - 37975500
AN - SCOPUS:85177071239
SN - 8755-6863
VL - 59
SP - 371
EP - 378
JO - Pediatric pulmonology
JF - Pediatric pulmonology
IS - 2
ER -