Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy a randomized trial

Rocco Trisolini, Alessandra Cancellieri, Carmine Tinelli, Daniela Paioli, Luigia Scudeller, Gian Piero Casadei, Sergio Forti Parri, Vanina Livi, Arrigo Bondi, Maurizio Boaron, Marco Patelli

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Background: Rapid on-site evaluation (ROSE) of transbronchial needle aspirates has long been used during flexible bronchoscopy, but its usefulness in the diagnosis of hilar and mediastinal adenopathy is controversial. The aim of the present study was to evaluate the extent to which ROSE can be valuable in patients undergoing transbronchial needle aspiration (TBNA) for the diagnosis of hilar and mediastinal adenopathy. Methods: A total of 168 consecutive patients with enlarged lymph nodes were randomized to undergo TBNA with or without ROSE. The primary outcome measure of the study was the diagnostic yield of TBNA on a per-patient basis. Secondary outcome measures included the percentage of adequate specimens on a per-lymph node basis, the number of biopsy sites on a per-patient basis, and the complication rate of bronchoscopy on a per-patient basis. Results: We found no significant difference between the TBNA group and the ROSE group in terms of diagnostic yield (75.3% vs 78.3%, respectively; P=.64), and percentage of adequate specimens (86.5% vs 78.4%, respectively; P=.11). The median (interquartile range) number of biopsy sites was significantly lower in the ROSE group (1 [1-2] vs 2 [1-2], respectively; P=.0005). The complication rate of bronchoscopy was significantly lower in patients undergoing on-site review (6% vs 20%;P=.01), whereas the complication rate of TBNA was similar among the study groups. Conclusions: ROSE of transbronchial aspirates from hilar and mediastinal nodes enables avoidance of additional biopsy without loss in diagnostic yield and reduces the complication rate of bronchoscopy. Trial registry: ClinicalTrials.gov; No.: NCT00915330; URL: www.clinicaltrials.gov.

Original languageEnglish
Pages (from-to)395-401
Number of pages7
JournalChest
Volume139
Issue number2
DOIs
Publication statusPublished - Feb 1 2011

Fingerprint

Needles
Bronchoscopy
Outcome Assessment (Health Care)
Biopsy
Lymph Nodes
Registries
Lymphadenopathy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy a randomized trial. / Trisolini, Rocco; Cancellieri, Alessandra; Tinelli, Carmine; Paioli, Daniela; Scudeller, Luigia; Casadei, Gian Piero; Parri, Sergio Forti; Livi, Vanina; Bondi, Arrigo; Boaron, Maurizio; Patelli, Marco.

In: Chest, Vol. 139, No. 2, 01.02.2011, p. 395-401.

Research output: Contribution to journalArticle

Trisolini, R, Cancellieri, A, Tinelli, C, Paioli, D, Scudeller, L, Casadei, GP, Parri, SF, Livi, V, Bondi, A, Boaron, M & Patelli, M 2011, 'Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy a randomized trial', Chest, vol. 139, no. 2, pp. 395-401. https://doi.org/10.1378/chest.10-1521
Trisolini, Rocco ; Cancellieri, Alessandra ; Tinelli, Carmine ; Paioli, Daniela ; Scudeller, Luigia ; Casadei, Gian Piero ; Parri, Sergio Forti ; Livi, Vanina ; Bondi, Arrigo ; Boaron, Maurizio ; Patelli, Marco. / Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy a randomized trial. In: Chest. 2011 ; Vol. 139, No. 2. pp. 395-401.
@article{25c076e1f18f4850b82b85241609d8dc,
title = "Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy a randomized trial",
abstract = "Background: Rapid on-site evaluation (ROSE) of transbronchial needle aspirates has long been used during flexible bronchoscopy, but its usefulness in the diagnosis of hilar and mediastinal adenopathy is controversial. The aim of the present study was to evaluate the extent to which ROSE can be valuable in patients undergoing transbronchial needle aspiration (TBNA) for the diagnosis of hilar and mediastinal adenopathy. Methods: A total of 168 consecutive patients with enlarged lymph nodes were randomized to undergo TBNA with or without ROSE. The primary outcome measure of the study was the diagnostic yield of TBNA on a per-patient basis. Secondary outcome measures included the percentage of adequate specimens on a per-lymph node basis, the number of biopsy sites on a per-patient basis, and the complication rate of bronchoscopy on a per-patient basis. Results: We found no significant difference between the TBNA group and the ROSE group in terms of diagnostic yield (75.3{\%} vs 78.3{\%}, respectively; P=.64), and percentage of adequate specimens (86.5{\%} vs 78.4{\%}, respectively; P=.11). The median (interquartile range) number of biopsy sites was significantly lower in the ROSE group (1 [1-2] vs 2 [1-2], respectively; P=.0005). The complication rate of bronchoscopy was significantly lower in patients undergoing on-site review (6{\%} vs 20{\%};P=.01), whereas the complication rate of TBNA was similar among the study groups. Conclusions: ROSE of transbronchial aspirates from hilar and mediastinal nodes enables avoidance of additional biopsy without loss in diagnostic yield and reduces the complication rate of bronchoscopy. Trial registry: ClinicalTrials.gov; No.: NCT00915330; URL: www.clinicaltrials.gov.",
author = "Rocco Trisolini and Alessandra Cancellieri and Carmine Tinelli and Daniela Paioli and Luigia Scudeller and Casadei, {Gian Piero} and Parri, {Sergio Forti} and Vanina Livi and Arrigo Bondi and Maurizio Boaron and Marco Patelli",
year = "2011",
month = "2",
day = "1",
doi = "10.1378/chest.10-1521",
language = "English",
volume = "139",
pages = "395--401",
journal = "Chest",
issn = "0012-3692",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Rapid on-site evaluation of transbronchial aspirates in the diagnosis of hilar and mediastinal adenopathy a randomized trial

AU - Trisolini, Rocco

AU - Cancellieri, Alessandra

AU - Tinelli, Carmine

AU - Paioli, Daniela

AU - Scudeller, Luigia

AU - Casadei, Gian Piero

AU - Parri, Sergio Forti

AU - Livi, Vanina

AU - Bondi, Arrigo

AU - Boaron, Maurizio

AU - Patelli, Marco

PY - 2011/2/1

Y1 - 2011/2/1

N2 - Background: Rapid on-site evaluation (ROSE) of transbronchial needle aspirates has long been used during flexible bronchoscopy, but its usefulness in the diagnosis of hilar and mediastinal adenopathy is controversial. The aim of the present study was to evaluate the extent to which ROSE can be valuable in patients undergoing transbronchial needle aspiration (TBNA) for the diagnosis of hilar and mediastinal adenopathy. Methods: A total of 168 consecutive patients with enlarged lymph nodes were randomized to undergo TBNA with or without ROSE. The primary outcome measure of the study was the diagnostic yield of TBNA on a per-patient basis. Secondary outcome measures included the percentage of adequate specimens on a per-lymph node basis, the number of biopsy sites on a per-patient basis, and the complication rate of bronchoscopy on a per-patient basis. Results: We found no significant difference between the TBNA group and the ROSE group in terms of diagnostic yield (75.3% vs 78.3%, respectively; P=.64), and percentage of adequate specimens (86.5% vs 78.4%, respectively; P=.11). The median (interquartile range) number of biopsy sites was significantly lower in the ROSE group (1 [1-2] vs 2 [1-2], respectively; P=.0005). The complication rate of bronchoscopy was significantly lower in patients undergoing on-site review (6% vs 20%;P=.01), whereas the complication rate of TBNA was similar among the study groups. Conclusions: ROSE of transbronchial aspirates from hilar and mediastinal nodes enables avoidance of additional biopsy without loss in diagnostic yield and reduces the complication rate of bronchoscopy. Trial registry: ClinicalTrials.gov; No.: NCT00915330; URL: www.clinicaltrials.gov.

AB - Background: Rapid on-site evaluation (ROSE) of transbronchial needle aspirates has long been used during flexible bronchoscopy, but its usefulness in the diagnosis of hilar and mediastinal adenopathy is controversial. The aim of the present study was to evaluate the extent to which ROSE can be valuable in patients undergoing transbronchial needle aspiration (TBNA) for the diagnosis of hilar and mediastinal adenopathy. Methods: A total of 168 consecutive patients with enlarged lymph nodes were randomized to undergo TBNA with or without ROSE. The primary outcome measure of the study was the diagnostic yield of TBNA on a per-patient basis. Secondary outcome measures included the percentage of adequate specimens on a per-lymph node basis, the number of biopsy sites on a per-patient basis, and the complication rate of bronchoscopy on a per-patient basis. Results: We found no significant difference between the TBNA group and the ROSE group in terms of diagnostic yield (75.3% vs 78.3%, respectively; P=.64), and percentage of adequate specimens (86.5% vs 78.4%, respectively; P=.11). The median (interquartile range) number of biopsy sites was significantly lower in the ROSE group (1 [1-2] vs 2 [1-2], respectively; P=.0005). The complication rate of bronchoscopy was significantly lower in patients undergoing on-site review (6% vs 20%;P=.01), whereas the complication rate of TBNA was similar among the study groups. Conclusions: ROSE of transbronchial aspirates from hilar and mediastinal nodes enables avoidance of additional biopsy without loss in diagnostic yield and reduces the complication rate of bronchoscopy. Trial registry: ClinicalTrials.gov; No.: NCT00915330; URL: www.clinicaltrials.gov.

UR - http://www.scopus.com/inward/record.url?scp=79551607174&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79551607174&partnerID=8YFLogxK

U2 - 10.1378/chest.10-1521

DO - 10.1378/chest.10-1521

M3 - Article

C2 - 21030491

AN - SCOPUS:79551607174

VL - 139

SP - 395

EP - 401

JO - Chest

JF - Chest

SN - 0012-3692

IS - 2

ER -