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Endobronchial ultrasound in the management of nonsmall cell lung cancer

Christophe Dooms, Inge Muylle, Jonas Yserbyt, Vincent Ninane
European Respiratory Review 2013 22: 169-177; DOI: 10.1183/09059180.00001113
Christophe Dooms
*Respiratory Division, University Hospitals Leuven, Leuven, Dept of Clinical and Experimental Medicine, KU LeuvenLeuven, #Dept of Clinical and Experimental Medicine, KU Leuven, Leuven, and ¶Chest Service, Saint-Pierre University Hospital, Brussels, Belgium.
*Respiratory Division, University Hospitals Leuven, Leuven, Dept of Clinical and Experimental Medicine, KU LeuvenLeuven, #Dept of Clinical and Experimental Medicine, KU Leuven, Leuven, and ¶Chest Service, Saint-Pierre University Hospital, Brussels, Belgium.
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Inge Muylle
*Respiratory Division, University Hospitals Leuven, Leuven, Dept of Clinical and Experimental Medicine, KU LeuvenLeuven, #Dept of Clinical and Experimental Medicine, KU Leuven, Leuven, and ¶Chest Service, Saint-Pierre University Hospital, Brussels, Belgium.
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Jonas Yserbyt
*Respiratory Division, University Hospitals Leuven, Leuven, Dept of Clinical and Experimental Medicine, KU LeuvenLeuven, #Dept of Clinical and Experimental Medicine, KU Leuven, Leuven, and ¶Chest Service, Saint-Pierre University Hospital, Brussels, Belgium.
*Respiratory Division, University Hospitals Leuven, Leuven, Dept of Clinical and Experimental Medicine, KU LeuvenLeuven, #Dept of Clinical and Experimental Medicine, KU Leuven, Leuven, and ¶Chest Service, Saint-Pierre University Hospital, Brussels, Belgium.
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Vincent Ninane
*Respiratory Division, University Hospitals Leuven, Leuven, Dept of Clinical and Experimental Medicine, KU LeuvenLeuven, #Dept of Clinical and Experimental Medicine, KU Leuven, Leuven, and ¶Chest Service, Saint-Pierre University Hospital, Brussels, Belgium.
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  • For correspondence: Vincent_ninane@stpierre-bru.be
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  • Figure 1.
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    Figure 1.

    A convex ultrasound transducer is located at the tip of a dedicated bronchoscope for peribronchial linear scanning (bottom). A radial ultrasound transducer miniprobe is introduced through the biopsy channel of a standard bronchoscope for endobronchial scanning (top).

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    Figure 2.

    The radial endobronchial ultrasound miniprobe can visualise a) normal lung parenchyma (“snow-storm” pattern) or b) solid peripheral pulmonary lesion.

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    Figure 3.

    a) White light and b) autofluorescence bronchoscopy of an early stage radio-occult squamous cell carcinoma, which has been proven invasive by radial endobronchial ultrasound miniprobe with filled balloon sheath (c and d). The ultrasound image (d) illustrates interruption of white “cartilage” line, as indicated by the arrows. RB: right bronchus.

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    Figure 4.

    a) White light bronchoscopy of an early stage radio-occult squamous cell carcinoma, which has been proven micro-invasive by radial endobronchial ultrasound miniprobe with filled balloon sheath (b), and on histopathology (c). The arrows in b) indicate the intact white “cartilage” line on the ultrasound image.

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    Figure 5.

    Schematic representation of the mediastinum and nodal stations that are accessible to EBUS. Ao: aorta; AP: pulmonary artery; Az: azygos vein; B: brachiocephalic artery; L: left; R: right. For precise borders of the nodal stations see [36].

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  • Table 1. Accessibility to nodal stations with different sampling techniques
    MediastinoscopyEBUS-TBNAEUS-FNA
    Supraclavicular zone
        1±–-–
    Superior mediastinal nodes
        2R++–
        2L+++
        4R++–
        4L+++
        3a–––
        3p_±#±#
    Aortic nodes
        5–––#
        6–––#
    Inferior mediastinal nodes
        7+++
        8––+
        9––+
    N1 nodes
        10 Hilar±+±#
        11 Interlobar–+–
        12 Lobar–+–
    • EBUS-TBNA: endobronchial ultrasound-transbronchial needle aspiration; EUS-FNA: endoscopic ultrasound-fine needle aspiration. +: accessible; –: inaccessible; ±: may be accessible. #: casuistic reports that it is feasible.

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    • V. Ninane
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Endobronchial ultrasound in the management of nonsmall cell lung cancer
Christophe Dooms, Inge Muylle, Jonas Yserbyt, Vincent Ninane
European Respiratory Review Jun 2013, 22 (128) 169-177; DOI: 10.1183/09059180.00001113

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Endobronchial ultrasound in the management of nonsmall cell lung cancer
Christophe Dooms, Inge Muylle, Jonas Yserbyt, Vincent Ninane
European Respiratory Review Jun 2013, 22 (128) 169-177; DOI: 10.1183/09059180.00001113
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  • Article
    • Abstract
    • CONVEX AND RADIAL PROBE EBUS: TECHNICAL AND PRACTICAL PATHOLOGICAL ASPECTS
    • RADIAL PROBE EBUS FOR PRIMARY TUMOUR STAGING (T-FACTOR)
    • CONVEX PROBE EBUS FOR MEDIASTINAL NODAL STAGING (N-FACTOR)
    • RADIAL PROBE EBUS FOR DIAGNOSIS OF PERIPHERAL PULMONARY LESIONS
    • CONVEX EBUS PROBE FOR THE DIAGNOSIS OF CENTRAL PARENCHYMAL LUNG CANCERS
    • CONCLUSIONS
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  • Lung cancer
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