A Retrospective Review of Different Methods of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: A Preliminary Study.

Transbronchial needle aspiration (TBNA) is a 30 year old procedure for diagnosing and staging of lung cancer. There has been renewed interest in TBNA due to the development of a curvilinear array endobronchial ultrasound (EBUS) scope for TBNA. Reports indicate an increased diagnostic yield compared to standard TBNA. In 9 of 11 patients EBUS-TBNA is performed with the second generation Olympus EBUS scope (BF-UC180F) and the ViziShot (NA-201SX-4022) needle in addition to the standard WANG™ TBNA needle. Three punctures were made by the ViziShot needle. The first puncture, the guidewire is partially retracted and without suction the needle is moved back and forth inside the lesion. The second puncture, the guidewire is completely removed and suction is applied during needle movement. The third puncture is without the guidewire but with suction. In five patients with a positive diagnosis of cancer, the first punctures were all positive with a better quality and quantity of tumor cells. Three patients, standard TBNA needle was used, all were positive. Four patients with standard TBNA preceded the EBUS-TBNA were all positive. We conclude, EBUS TBNA is highly effective and dependable and suggest the use of EBUS needle can be simplified. Standard TBNA needle can be used for EBUS-TBNA and standard TBNA in relation to EBUS-TBNA needs to be further investigated.