CC BY-NC-ND 4.0 · Avicenna J Med 2015; 05(03): 57-66
DOI: 10.4103/2231-0770.160229
REVIEW ARTICLE

Advances in diagnostic interventional pulmonology

Nassar Al-Zubaidi
Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
,
Ayman O Soubani
Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
› Author Affiliations

Abstract

The recent advances in diagnostic pulmonary procedures have revolutionized the evaluation of abnormal thoracic findings including lung nodules and masses, mediastinal lymphadenopathy, and pleural diseases. Bronchoscopies with endobronchial ultrasonography and electromagnetic navigation are examples of new technology that has significantly improved the specificity and sensitivity of these procedures in diagnosis and staging of lung cancer without the need for more invasive procedures. This report describes the different diagnostic pulmonary interventions providing a description of the procedures, their indications, diagnostic yield and drawback.



Publication History

Article published online:
09 August 2021

© 2015. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Haas AR, Vachani A, Sterman DH. Advances in diagnostic bronchoscopy. Am J Respir Crit Care Med 2010;182:589-97.
  • 2 Ikeda S, Yanai N, Ishikawa S. Flexible bronchofiberscope. Keio J Med 1968;17:1-16.
  • 3 Becker HD. Bronchoscopy: The past, the present, and the future. Clin Chest Med 2010;31:1-18.
  • 4 Casal RF, Ost DE, Eapen GA. Flexible bronchoscopy. Clin Chest Med 2013;34:341-52.
  • 5 Mason RJ, Broaddus VC, Murray JF, Nadel JA. In: Murray and Nadel editors. Textbook of Respiratory Medicine. 4 th ed. Philadelphia, Pa, USA: Elsevier-Saunders; 2005.
  • 6 Funahashi A, Lohaus GH, Politis J, Hranicka LJ. Role of fibreoptic bronchoscopy in the diagnosis of mycobacterial diseases. Thorax 1983;38:267-70.
  • 7 Baughman RP. Use of bronchoscopy in the diagnosis of infection in the immunocompromised host. Thorax 1994;49:3-7.
  • 8 Jain P, Sandur S, Meli Y, Arroliga AC, Stoller JK, Mehta AC. Role of flexible bronchoscopy in immunocompromised patients with lung infiltrates. Chest 2004;125:712-22.
  • 9 Ensminger SA, Prakash UB. Is bronchoscopic lung biopsy helpful in the management of patients with diffuse lung disease? Eur Respir J 2006;28:1081-4.
  • 10 Rittirak W, Sompradeekul S. Diagnostic yield of fluoroscopy-guided transbronchial lung biopsy in non-endobronchial lung lesion. J Med Assoc Thai 2007;90 Suppl 2:68-73.
  • 11 Schenk DA, Bower JH, Bryan CL, Currie RB, Spence TH, Duncan CA, et al. Transbronchial needle aspiration staging of bronchogenic carcinoma. Am Rev Respir Dis 1986;134:146-8.
  • 12 Ernst A, Eberhardt R, Wahidi M, Becker HD, Herth FJ. Effect of routine clopidogrel use on bleeding complications after transbronchial biopsy in humans. Chest 2006;129:734-7.
  • 13 Hürter T, Hanrath P. Endobronchial sonography: Feasibility and preliminary results. Thorax 1992;47:565-7.
  • 14 Kurimoto N, Murayama M, Yoshioka S, Nishisaka T, Inai K, Dohi K. Assessment of usefulness of endobronchial ultrasonography in determination of depth of tracheobronchial tumor invasion. Chest 1999;115:1500-6.
  • 15 Tanaka F, Muro K, Yamasaki S, Watanabe G, Shimada Y, Imamura M, et al. Evaluation of tracheo-bronchial wall invasion using transbronchial ultrasonography (TBUS). Eur J Cardiothorac Surg 2000;17:570-4.
  • 16 Baba M, Sekine Y, Suzuki M, Yoshida S, Shibuya K, Iizasa T, et al. Correlation between endobronchial ultrasonography (EBUS) images and histologic findings in normal and tumor-invaded bronchial wall. Lung Cancer 2002;35:65-71.
  • 17 Herth F, Ernst A, Schulz M, Becker H. Endobronchial ultrasound reliably differentiates between airway infiltration and compression by tumor. Chest 2003;123:458-62.
  • 18 Herth FJ, Becker HD, Ernst A. Ultrasound-guided transbronchial needle aspiration: An experience in 242 patients. Chest 2003;123:604-7.
  • 19 Herth F, Becker HD, Ernst A. Conventional vs endobronchial ultrasound-guided transbronchial needle aspiration: A randomized trial. Chest 2004;125:322-5.
  • 20 Herth FJ, Lunn W, Eberhardt R, Becker HD, Ernst A. Transbronchial versus transesophageal ultrasound-guided aspiration of enlarged mediastinal lymph nodes. Am J Respir Crit Care Med 2005;171:1164-7.
  • 21 Kurimoto N, Murayama M, Yoshioka S, Nishisaka T. Analysis of the internal structure of peripheral pulmonary lesions using endobronchial ultrasonography. Chest 2002;122:1887-94.
  • 22 Chao TY, Lie CH, Chung YH, Wang JL, Wang YH, Lin MC. Differentiating peripheral pulmonary lesions based on images of endobronchial ultrasonography. Chest 2006;130:1191-7.
  • 23 Herth FJ, Eberhardt R, Becker HD, Ernst A. Endobronchial ultrasound-guided transbronchial lung biopsy in fluoroscopically invisible solitary pulmonary nodules: A prospective trial. Chest 2006;129:147-50.
  • 24 Kurimoto N, Miyazawa T, Okimasa S, Maeda A, Oiwa H, Miyazu Y, et al. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically. Chest 2004;126:959-65.
  • 25 Steinfort DP, Khor YH, Manser RL, Irving LB. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: Systematic review and meta-analysis. Eur Respir J 2011;37:902-10.
  • 26 Wang Memoli JS, Nietert PJ, Silvestri GA. Meta-analysis of guided bronchoscopy for the evaluation of the pulmonary nodule. Chest 2012;142:385-93.
  • 27 Czarnecka K, Yasufuku K. Interventional pulmonology: Focus on pulmonary diagnostics. Respirology 2013;18:47-60.
  • 28 Yasufuku K, Chiyo M, Sekine Y, Chhajed PN, Shibuya K, Iizasa T, et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest 2004;126:122-8.
  • 29 Gu P, Zhao YZ, Jiang LY, Zhang W, Xin Y, Han BH. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: A systematic review and meta-analysis. Eur J Cancer 2009;45:1389-96.
  • 30 Dong X, Qiu X, Liu Q, Jia J. Endobronchial ultrasound-guided transbronchial needle aspiration in the mediastinal staging of non-small cell lung cancer: A meta-analysis. Ann Thorac Surg 2013;96:1502-7.
  • 31 Varela-Lema L, Fernández-Villar A, Ruano-Ravina A. Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration: A systematic review. Eur Respir J 2009;33:1156-64.
  • 32 Yasufuku K, Pierre A, Darling G, de Perrot M, Waddell T, Johnston M, et al. A prospective controlled trial of endobronchial ultrasound-guided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph node staging of lung cancer. J Thorac Cardiovasc Surg 2011;142:1393-400.e1.
  • 33 Andrade RS, Podgaetz E, Rueth NM, Majumder K, Hall E, Saric C, et al. Endobronchial ultrasonography versus mediastinoscopy: A single-institution cost analysis and waste comparison. Ann Thorac Surg 2014;98:1003-7.
  • 34 Fritscher-Ravens A, Davidson BL, Hauber HP, Bohuslavizki KH, Bobrowski C, Lund C, et al. Endoscopic ultrasound, positron emission tomography, and computerized tomography for lung cancer. Am J Respir Crit Care Med 2003;168:1293-7.
  • 35 Tremblay A, Stather DR, Maceachern P, Khalil M, Field SK. A randomized controlled trial of standard vs endobronchial ultrasonography-guided transbronchial needle aspiration in patients with suspected sarcoidosis. Chest 2009;136:340-6.
  • 36 Agarwal R, Srinivasan A, Aggarwal AN, Gupta D. Efficacy and safety of convex probe EBUS-TBNA in sarcoidosis: A systematic review and meta-analysis. Respir Med 2012;106:883-92.
  • 37 Asano F, Aoe M, Ohsaki Y, Okada Y, Sasada S, Sato S, et al. Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: A nationwide survey by the Japan Society for Respiratory Endoscopy. Respir Res 2013;14:50.
  • 38 Haas AR, Vachani A, Sterman DH. Advances in diagnostic bronchoscopy. Am J Respir Crit Care Med 2010;182:589-97.
  • 39 Schwarz Y, Mehta AC, Ernst A, Herth F, Engel A, Besser D, et al. Electromagnetic navigation during flexible bronchoscopy. Respiration 2003;70:516-22.
  • 40 Leong S, Ju H, Marshall H, Bowman R, Yang I, Ree AM, et al. Electromagnetic navigation bronchoscopy: A descriptive analysis. J Thorac Dis 2012;4:173-85.
  • 41 Schwarz Y, Greif J, Becker HD, Ernst A, Mehta A. Real-time electromagnetic navigation bronchoscopy to peripheral lung lesions using overlaid CT images: The first human study. Chest 2006;129:988-94.
  • 42 Lamprecht B, Porsch P, Pirich C, Studnicka M. Electromagnetic navigation bronchoscopy in combination with PET-CT and rapid on-site cytopathologic examination for diagnosis of peripheral lung lesions. Lung 2009;187:55-9.
  • 43 Makris D, Scherpereel A, Leroy S, Bouchindhomme B, Faivre JB, Remy J, et al. Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions. Eur Respir J 2007;29:1187-92.
  • 44 Eberhardt R, Anantham D, Herth F, Feller-Kopman D, Ernst A. Electromagnetic navigation diagnostic bronchoscopy in peripheral lung lesions. Chest 2007;131:1800-5.
  • 45 Eberhardt R, Anantham D, Ernst A, Feller-Kopman D, Herth F. Multimodality bronchoscopic diagnosis of peripheral lung lesions: A randomized controlled trial. Am J Respir Crit Care Med 2007;176:36-41.
  • 46 Gex G, Pralong JA, Combescure C, Seijo L, Rochat T, Soccal PM. Diagnostic yield and safety of electromagnetic navigation bronchoscopy for lung nodules: A systematic review and meta-analysis. Respiration 2014;87:165-76.
  • 47 Dale CR, Madtes DK, Fan VS, Gorden JA, Veenstra DL. Navigational bronchoscopy with biopsy versus computed tomography-guided biopsy for the diagnosis of a solitary pulmonary nodule: A cost-consequences analysis. J Bronchology Interv Pulmonol 2012;19:294-303.
  • 48 Seijo LM, de Torres JP, Lozano MD, Bastarrika G, Alcaide AB, Lacunza MM, et al. Diagnostic yield of electromagnetic navigation bronchoscopy is highly dependent on the presence of a Bronchus sign on CT imaging: Results from a prospective study. Chest 2010;138:1316-21.
  • 49 Gordon S. Clinical reports of rare cases, occurring in the Whit worth and Hardwicke Hospitals: Most extensive pleuritic effusion rapidly becoming purulent, paracentesis, introduction of a drainage tube, recovery, examination of interior of pleura by the endoscope. Dubl Q J Med Sci 1866;41:83-90.
  • 50 Jacobaeus HC. The Possibilities for Performing Cystoscopy in Examinations of Serous Cavities (Uber die Moglichkeit, die Zystoskopie bei Untersuchungen seroser Hohlungenanzuwenden). Munch Med Wochenschr 1910;40:2090-2.
  • 51 Lee P, Colt HG. Pleuroscopy in 2013. Clin Chest Med 2013;34:81-91.
  • 52 Bhatnagar R, Maskell NA. Medical pleuroscopy. Clin Chest Med 2013;34:487-500.
  • 53 Munavvar M, Khan MA, Edwards J, Waqaruddin Z, Mills J. The autoclavable semirigid thoracoscope: The way forward in pleural disease? Eur Respir J 2007;29:571-4.
  • 54 Rozman A, Camlek L, Kern I, Malovrh MM. Semirigid thoracoscopy: An effective method for diagnosing pleural malignancies. Radiol Oncol 2014;48:67-71.
  • 55 Wilsher ML, Veale AG. Medical thoracoscopy in the diagnosis of unexplained pleural effusion. Respirology 1998;3:77-80.
  • 56 Rodgers BM, Moazam F, Talbert JL. Thoracoscopy. Early diagnosis of interstitial pneumonitis in the immunologically suppressed child. Chest 1979;75:126-30.
  • 57 Vansteenkiste J, Verbeken E, Thomeer M, Van Haecke P, Eeckhout AV, Demedts M. Medical thoracoscopic lung biopsy in interstitial lung disease: A prospective study of biopsy quality. Eur Respir J 1999;14:585-90.
  • 58 Kern L, Robert J, Brutsche M. Management of parapneumonic effusion and empyema: Medical thoracoscopy and surgical approach. Respiration 2011;82:193-6.
  • 59 Weissberg D, Kaufmann M. Diagnostic and therapeutic pleuroscopy. Experience with 127 patients. Chest 1980;78:732-5.
  • 60 Sakuraba M, Masuda K, Hebisawa A, Sagara Y, Komatsu H. Diagnostic value of thoracoscopic pleural biopsy for pleurisy under local anaesthesia. ANZ J Surg 2006;76:722-4.
  • 61 Davies HE, Nicholson JE, Rahman NM, Wilkinson EM, Davies RJ, Lee YC. Outcome of patients with nonspecific pleuritis/fibrosis on thoracoscopic pleural biopsies. Eur J Cardiothorac Surg 2010;38:472-7.
  • 62 Maskell NA, Butland RJ, Pleural Diseases Group, Standards of Care Committee, British Thoracic Society. BTS guidelines for the investigation of a unilateral pleural effusion in adults. Thorax 2003;58 Suppl 2:ii8-17.
  • 63 Diacon AH, Van de Wal BW, Wyser C, Smedema JP, Bezuidenhout J, Bolliger CT, et al. Diagnostic tools in tuberculous pleurisy: A direct comparative study. Eur Respir J 2003;22:589-91.
  • 64 Loddenkemper R, Mai J, Scheffler N, Brandt HJ. Prospective individual comparison of blind needle biopsy and of thoracoscopy in the diagnosis and differential diagnosis of tuberculous pleurisy. Scand J Respir Dis Suppl 1978;102:196-8.
  • 65 Brims FJ, Arif M, Chauhan AJ. Outcomes and complications following medical thoracoscopy. Clin Respir J 2012;6:144-9.
  • 66 Metintas M, Ak G, Yildirim H, Danacioglu S, Dundar E, Metintas S. The safety of medical thoracoscopy in a group at high risk for complications. J Bronchology Interv Pulmonol 2013;20:224-31.
  • 67 Asano F. Virtual bronchoscopic navigation. Clin Chest Med 2010;31:75-85.
  • 68 Amorico MG, Drago A, Vetruccio E, Bollino F, Pizzuti G, Gallo E. Tracheobronchial stenosis: Role of virtual endoscopy in diagnosis and follow-up after therapy. Radiol Med 2006;111:1064-77.
  • 69 Shinagawa N, Yamazaki K, Onodera Y, Asahina H, Kikuchi E, Asano F, et al. Factors related to diagnostic sensitivity using an ultrathin bronchoscope under CT guidance. Chest 2007;131:549-53.
  • 70 Tachihara M, Ishida T, Kanazawa K, Sugawara A, Watanabe K, Uekita K, et al. A virtual bronchoscopic navigation system under X-ray fluoroscopy for transbronchial diagnosis of small peripheral pulmonary lesions. Lung Cancer 2007;57:322-7.
  • 71 Asahina H, Yamazaki K, Onodera Y, Kikuchi E, Shinagawa N, Asano F, et al. Transbronchial biopsy using endobronchial ultrasonography with a guide sheath and virtual bronchoscopic navigation. Chest 2005;128:1761-5.
  • 72 Lacasse Y, Martel S, Hébert A, Carrier G, Raby B. Accuracy of virtual bronchoscopy to detect endobronchial lesions. Ann Thorac Surg 2004;77:1774-80.
  • 73 Zaric B, Perin B, Becker HD, Herth FF, Eberhardt R, Djuric M, et al. Autofluorescence imaging videobronchoscopy in the detection of lung cancer: From research tool to everyday procedure. Expert Rev Med Devices 2011;8:167-72.
  • 74 Chen W, Gao X, Tian Q, Chen L. A comparison of autofluorescence bronchoscopy and white light bronchoscopy in detection of lung cancer and preneoplastic lesions: A meta-analysis. Lung Cancer 2011;73:183-8.
  • 75 van Rens MT, Schramel FM, Elbers JR, Lammers JW. The clinical value of lung imaging fluorescence endoscopy for detecting synchronous lung cancer. Lung Cancer 2001;32:13-8.
  • 76 Piérard P, Faber J, Hutsebaut J, Martin B, Plat G, Sculier JP, et al. Synchronous lesions detected by autofluorescence bronchoscopy in patients with high-grade preinvasive lesions and occult invasive squamous cell carcinoma of the proximal airways. Lung Cancer 2004;46:341-7.
  • 77 Breuer RH, Pasic A, Smit EF, van Vliet E, Vonk Noordegraaf A, Risse EJ, et al. The natural course of preneoplastic lesions in bronchial epithelium. Clin Cancer Res 2005;11:537-43.
  • 78 Kennedy TC, McWilliams A, Edell E, Sutedja T, Downie G, Yung R, et al. Bronchial intraepithelial neoplasia/early central airways lung cancer: ACCP evidence-based clinical practice guidelines (2 nd edition). Chest 2007;132:221S-33.
  • 79 Shibuya K, Nakajima T, Fujiwara T, Chiyo M, Hoshino H, Moriya Y, et al. Narrow band imaging with high-resolution bronchovideoscopy: A new approach for visualizing angiogenesis in squamous cell carcinoma of the lung. Lung Cancer 2010;69:194-202.
  • 80 Shibuya K, Hoshino H, Chiyo M, Iyoda A, Yoshida S, Sekine Y, et al. High magnification bronchovideoscopy combined with narrow band imaging could detect capillary loops of angiogenic squamous dysplasia in heavy smokers at high risk for lung cancer. Thorax 2003;58:989-95.
  • 81 Herth FJ, Eberhardt R, Anantham D, Gompelmann D, Zakaria MW, Ernst A. Narrow-band imaging bronchoscopy increases the specificity of bronchoscopic early lung cancer detection. J Thorac Oncol 2009;4:1060-5.