Inderpaul Singh Sehgal1, Sahajal Dhooria1, Ashutosh Nath Aggarwal1, Ritesh Agarwal2. 1. Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 2. Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: agarwal.ritesh@outlook.in.
Abstract
BACKGROUND: Whether the use of rapid on-site cytologic evaluation (ROSE) increases the diagnostic yield of transbronchial needle aspiration (TBNA) remains unclear. This article is a systematic review of studies describing the utility of ROSE in subjects undergoing TBNA. METHODS: The study included a systematic review of the PubMed, Embase, and Scopus databases for randomized controlled trials investigating the diagnostic yield of conventional transbronchial needle aspiration (c-TBNA) or endobronchial ultrasound (EBUS)-TBNA, with or without ROSE, in subjects with mediastinal lymphadenopathy. RESULTS: Five studies (618 subjects; two EBUS-TBNA, two c-TBNA, and one both) were identified. Overall, the studies were of good quality. The pooled risk difference (95% CI) of the diagnostic yield of EBUS-TBNA and c-TBNA was 0.04 (-0.01 to 0.09) and 0.12 (-0.08 to 0.33), respectively, suggesting no added benefit with ROSE. The use of ROSE during EBUS-TBNA (but not c-TBNA) resulted in significantly fewer needle passes (mean difference [95% CI], -1.1 [-2.2 to -0.005]; P < .001). There was no difference in the procedure time during EBUS-TBNA. The complication rate was significantly lower (OR [95% CI], 0.26 [0.10 to 0.71]; P = .009) when ROSE was used during c-TBNA due to fewer additional procedures required to make a diagnosis. There was evidence of heterogeneity in the studies involving c-TBNA but not EBUS-TBNA. There was no publication bias. CONCLUSIONS: The use of ROSE neither improved the diagnostic yield nor reduced the procedure time during TBNA. However, the use of ROSE was associated with fewer number of needle passes during EBUS-TBNA and overall lower requirement for additional bronchoscopy procedures during TBNA to make a final diagnosis. TRIAL REGISTRY: PROSPERO; No.: CRD42017058937; URL: www.crd.york.ac.uk/prospero/.
BACKGROUND: Whether the use of rapid on-site cytologic evaluation (ROSE) increases the diagnostic yield of transbronchial needle aspiration (TBNA) remains unclear. This article is a systematic review of studies describing the utility of ROSE in subjects undergoing TBNA. METHODS: The study included a systematic review of the PubMed, Embase, and Scopus databases for randomized controlled trials investigating the diagnostic yield of conventional transbronchial needle aspiration (c-TBNA) or endobronchial ultrasound (EBUS)-TBNA, with or without ROSE, in subjects with mediastinal lymphadenopathy. RESULTS: Five studies (618 subjects; two EBUS-TBNA, two c-TBNA, and one both) were identified. Overall, the studies were of good quality. The pooled risk difference (95% CI) of the diagnostic yield of EBUS-TBNA and c-TBNA was 0.04 (-0.01 to 0.09) and 0.12 (-0.08 to 0.33), respectively, suggesting no added benefit with ROSE. The use of ROSE during EBUS-TBNA (but not c-TBNA) resulted in significantly fewer needle passes (mean difference [95% CI], -1.1 [-2.2 to -0.005]; P < .001). There was no difference in the procedure time during EBUS-TBNA. The complication rate was significantly lower (OR [95% CI], 0.26 [0.10 to 0.71]; P = .009) when ROSE was used during c-TBNA due to fewer additional procedures required to make a diagnosis. There was evidence of heterogeneity in the studies involving c-TBNA but not EBUS-TBNA. There was no publication bias. CONCLUSIONS: The use of ROSE neither improved the diagnostic yield nor reduced the procedure time during TBNA. However, the use of ROSE was associated with fewer number of needle passes during EBUS-TBNA and overall lower requirement for additional bronchoscopy procedures during TBNA to make a final diagnosis. TRIAL REGISTRY: PROSPERO; No.: CRD42017058937; URL: www.crd.york.ac.uk/prospero/.
Authors: Maria-Rosa Ghigna; Adrian Crutu; Valentina Florea; Séverine Feuillet-Soummer; Pierre Baldeyrou; Julien Adam; Ludovic Lacroix; Benjamin Besse; Olaf Mercier; Elie Fadel; Peter Dorfmuller; Rida El Ayoubi; Vincent Thomas de Montpréville Journal: J Thorac Dis Date: 2018-07 Impact factor: 2.895
Authors: Thomas R Gildea; Erik E Folch; Sandeep J Khandhar; Michael A Pritchett; Gregory P LeMense; Philip A Linden; Douglas A Arenberg; Otis B Rickman; Amit K Mahajan; Jaspal Singh; Joseph Cicenia; Atul C Mehta; Haiying Lin; Jennifer S Mattingley Journal: J Bronchology Interv Pulmonol Date: 2021-07-01