Endobronchial ultrasound (EBUS), a new technique for diagnosis of lung tumor
The world’s leading EBUS was introduced into our hospital in 2013. During the half of year, 75 cases were diagnosed as lung cancer in about 100 cases by use of the advanced device. The specimen obtained by the device is multipurpose, for example smear test, liquid based cytology, immunohistochemistry for linear tissue, and gene test evenly. Based on the personalized data, our diagnosis ability has been improved significantly, achieving the leading level in Zhejiang Province. Of note, some non-tumor diseases, for example sarcoidosis, in the mediastinum were difficult to diagnose previously. Nowadays, we can make it easily using the EBUS. There have been 3 cases of sarcoidosis diagnosed on the histopathological level using the EBUS-TBNA during the half of year.
Besides, our hospital introduced the radial probe endobronchial ultrasound (RP-EBUS). As application, the lesion is found by the radial probe, to where the sheath was guided afterwards. Biopsy and brushing can be performed through the guiding sheath after withdrawing the radial probe. Using the tecHnique, the Dept. of pulmonary medicine in our hospital made a biopsy of peripheral lung tissue recently. It’s the first time in the Zhejiang Province. The lesion of the case lies in the right middle lobe near the heart. It’s at risk to take a percutaneous lung puncture biopsy guided by CT. The team led by the director Liming Wang co-operated with the radiologist Bin Yang to deal with the case. They located the lesion accurately and made sufficient preparations for the biopsy. After local anesthesia and sedation, the bronchoscope was pushed to the aim bronchi, after which the UM-S20-20R radial probe was introduced to lesion through the working aisle of the bronchoscope. The biopsy and smearing were performed after the RP-EBUS detected and located the suspected lesion. Meanwhile, the patient was also performed EBUS-TBNA for the enlarged mediastinal lymph nodes. The pathology showed as lung adenocarcinoma. After that, the team performed 6 cases in succession, achieving a positive rate of 70%.
Biopsy in peripheral lung tissue guided by RP-EBUS is an advanced technique of EBUS. It not only provides the quality ultrasound image, but also locates the lesion and enlarged lymph nodes accurately, which improve the efficiency, precision and safety of peripheral lung biopsy.
To date, only few hospitals master the technique in China and our hospital is the unique in the Zhejiang Province.