Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

The increasing use of minimally invasive techniques has renewed interest in transbronchial needle aspiration (TBNA) for obtaining biopsies of mediastinal lymph nodes. However, conventional TBNA relies on "blind'' needle puncture guided only by static computed tomography scans. The success of the technique is highly operator-dependent: reported sensitivities vary between 15% and 78%. In addition, many pulmonologists are so discouraged by the results of their initial experience with the technique that only 20% to 30% use TBNA. Here, we describe our technique for performing endobronchial ultrasound-TBNA using a curved linear array ultrasonic bronchoscope that allows aspiration biopsy under real-time ultrasound imaging.