The role of sonographic patterns during endobronchial ultrasound-transbronchial needle aspiration for lung cancer staging: A narrative review

Mario Nosotti, Michele Ferrari, Ilaria Righi, Paolo Mendogni, Francesco Damarco, Margherita Cattaneo, Lorenzo Rosso

Research output: Contribution to journalReview articlepeer-review

Abstract

In lung cancer accurate assessment of the mediastinal lymph node status is of paramount importance for the stage assignment as well as crucial for the therapeutic plan. TAC and positron emission tomography (PET) are valuable tools to achieve a preliminary picture of the mediastinal staging but Endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) is considered the first choice for investigating mediastinal lymph nodes as recommended by updated guide-lines. Despite the EBUS-TBNA sensitivity is satisfactory, it is not high enough to exclude mediastinal lymph node metastases; therefore devices and technologies were implemented to increase its sensitivity. The purpose of this narrative review is to describe the tools aimed at correctly interpreting sonographic patterns during EBUS and maximizing the diagnostic accuracy of TBNA. The bibliographic research identified 354 articles potentially related to the purpose of the current review and after accurate reading we selected 21 articles. Eight articles focused on the sonographic features of lymph nodes found during EBUS, 2 papers considered the Doppler patterns and, finally, 18 studies analyzed the advantages of ultrasound elastography. Sonographic features, vascular patterns and ultrasound elastography have proved to be helpful in directing the operator to biopsy the most suspect lymph node, especially in patients with CT-negative and/or PET-negative mediastinum.

Original languageEnglish
Article numberA3
JournalMediastinum
Volume5
DOIs
Publication statusPublished - 2021

Keywords

  • Endobronchial ultrasound (EBUS)
  • Mediastinal staging
  • Non-small cell lung cancer (NSCLC)
  • Sonographic pattern

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pulmonary and Respiratory Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine
  • Oncology
  • Radiology Nuclear Medicine and imaging

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