Endobronchial Ultrasound for the Diagnosis of Centrally Located Lung Tumors: A Systematic Review and Meta-Analysis

Abstract Introduction: Obtaining a tissue diagnosis of centrally located lung tumors in patients presenting without endobronchial abnormalities is challenging, and therefore a considerable diagnostic problem. Objective: The objective of this study was to evaluate the performance of linear endobronch...

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Published in:Respiration Vol. 99; no. 5; pp. 441 - 450
Main Authors: Kuijvenhoven, Jolanda C., Leoncini, Fausto, Crombag, Laurence C., Spijker, René, Bonta, Peter I., Korevaar, Daniël A., Annema, Jouke T.
Format: Journal Article
Language:English
Published: Basel, Switzerland S. Karger AG 01.05.2020
Subjects:
Biopsy, Needle - methods
Bronchoscopy
Diagnosis
Diagnosis, Ultrasonic
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endosonography
Humans
Image-Guided Biopsy - methods
Lung Neoplasms - diagnosis
Lung Neoplasms - pathology
Lung tumors
Methods
Review
Sensitivity and Specificity
Netherlands
Tumor
Diagnosis
Endobronchial ultrasound
Lung cancer
ISSN:0025-7931, 1423-0356, 1423-0356
Online Access:Get full text
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Summary:Abstract Introduction: Obtaining a tissue diagnosis of centrally located lung tumors in patients presenting without endobronchial abnormalities is challenging, and therefore a considerable diagnostic problem. Objective: The objective of this study was to evaluate the performance of linear endobronchial ultrasound guided-transbronchial-needle aspiration (EBUS-TBNA) for the diagnosis of centrally located lung tumors. Methods: We performed a systematic review (PROSPERO, CRD42017080968) and searched MEDLINE, Embase, BIOSIS Previews, and Web of Science till November 18, 2018 for studies that evaluated the yield and/or sensitivity of EBUS-TBNA for diagnosing centrally located lung tumors. We assessed the study quality using QUADAS-2 and performed random-effects meta-analysis. Results: A total of 5,657 manuscripts were identified; of these 14 were considered for the study, including 1,175 patients who underwent EBUS-TBNA for diagnosing an intrapulmonary tumor. All studies had a high risk of bias or applicability concerns, predominately regarding patient selection. The average yield of EBUS-TBNA for diagnosing centrally located lung tumors was 0.89 (95% CI 0.84–0.92) and average sensitivity for diagnosing malignant tumors was 0.91 (95% CI 0.88–0.94). Among studies reporting this information, EBUS-related complications occurred in 5.4% of patients (42/721). Conclusion: EBUS-TBNA has a high yield and sensitivity for diagnosing centrally located lung tumors and is safe in selected patients. Prospective studies are recommended to evaluate the routine use of this procedure for diagnosing intrapulmonary tumors.
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ISSN:0025-7931
1423-0356
1423-0356
DOI:10.1159/000500363