Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Lung Cancer Diagnosis

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has transformed the diagnostic pathway for suspected lung cancer by combining real-time imaging of the airways with minimally invasive tissue sampling. Utilising a bronchoscope equipped with an ultrasound probe, clinicians can visualise mediastinal and hilar lymph nodes and obtain cytological and histological material via a fine needle. This approach enables accurate nodal staging, facilitates molecular profiling of non-small-cell lung cancer and guides personalised treatment decisions without the need for surgical mediastinoscopy. The procedure typically requires conscious sedation, carries a low risk of complications and can be performed on an outpatient basis. Technological refinements, such as elastography to characterise tissue stiffness and adjunctive cryobiopsy to increase tissue yield, have further enhanced diagnostic sensitivity. Globally, EBUS-TBNA has become the standard initial investigation for staging and diagnosis of lung cancer, reducing diagnostic delay and supporting the implementation of novel targeted therapies and immunotherapies.

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Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Lung Cancer Diagnosis publication trend

The graph below shows the total number of articles in endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer diagnosis across all publications each year (not limited to Nature Index journals).

Technical terms

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): A bronchoscopic technique using ultrasound guidance to visualise and sample mediastinal and hilar lymph nodes via fine-needle aspiration.

Mediastinal lymph node station: Anatomical regions of lymph nodes within the mediastinum, numbered according to standard classification for staging and procedural targeting.

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA): A complementary procedure using a gastrointestinal echoendoscope to access and sample posterior mediastinal nodes not reachable by EBUS-TBNA.

Cryobiopsy: A technique employing a cryoprobe to freeze and extract larger, contiguous tissue samples, enhancing histological and molecular analysis beyond standard needle aspiration.

References

1. Proposed quality indicators and recommended standard reporting items in performance of EBUS bronchoscopy: An official World Association for Bronchology and Interventional Pulmonology Expert Panel consensus statement. Respirology (2023).
2. Comparison of cryobiopsy and forceps biopsy for the diagnosis of mediastinal lesions: A randomised clinical trial. Pulmonology (2024).
3. Improved Accuracy and Sensitivity in Diagnosis and Staging of Lung Cancer with Systematic and Combined Endobronchial and Endoscopic Ultrasound (EBUS-EUS): Experience from a Tertiary Center. Cancers (2024).
4. Endobronchial ultrasound elastography strain ratio for mediastinal lymph node diagnosis. Radiology and Oncology (2015).
5. Potential application of cryobiopsy for histo-molecular characterization of mediastinal lymph nodes in patients with thoracic malignancies: a case presentation series and implications for future developments. BMC Pulmonary Medicine (2022).