What is EBUS (Endobronchial ultrasound) and EBUS Trans Bronchial Needle Aspiration (TBNA)?
This is a special diagnostic procedure done with a special type of ultrasonic bronchoscope called ‘EBUS scope’ which has an ultrasound probe at the tip of the bronchoscope. The ultrasound probe at the tip of bronchoscope helps in visualising the lesions which are present outside the airway wall in the mediastinum (mediastinum is the space between both lungs). This visualization helps the bronchoscopist to sample the mediastinal nodes, masses or cysts with the help of a needle under real-time guidance (EBUS TBNA). Conventionally “Blind TBNA” has been used for this purpose.
What is the advantage of EBUS TBNA over conventional “Blind TBNA”?
EBUS TBNA is more accurate and precise than “Blind TBNA”. The real-time guidance provided by the ultrasonic bronchoscope helps in visualizing the exact structure of the sample, visualize blood vessels near the lesion and simultaneously gives an endoscopic image. Lesions can be sampled under guidance which is the biggest advantage over blind TBNA. This decreases the complication rate. The combination of EBUS TBNA and EUS FNA have been touted as an equally better alternative to mediastinoscopy. The combination, in fact, has been called as “Medical mediastinoscopy”
What are the indications for EBUS TBNA?
The common indications of EBUS TBNA are
• Infections- Tuberculosis, fungal infections
• Diagnosis and staging of lung cancer
• Diagnosis of unknown or known metastatic cancers