Diagnostic yield of linear and radial endobronchial ultrasound in 558 patients of Fundacion Neumologica Colombiana and effect of rapid on-site cytological evaluation (ROSE)
L. Giraldo-Cadavid*a (Dr), N. Paezb (Dr), J. Mugnierc (Dr), L. Violad (Dr), L. Jimenez-Maldonadod (Dr), M. Suarezd (Dr), M. Durand (Dr), H. Herrerac (Dr), J. Flandese (Dr)
a Fundación Neumológica Colombiana; Universidad de La Sabana, Bogotá, COLOMBIA ; b Fundación Neumológica Colombiana, Bogotá, COLOMBIA ; c La Cardio, Bogota, COLOMBIA ; d Fundacion Neumologica Colombiana, Bogota, COLOMBIA ; e Fundacion Jimenez-Diaz, Madrid, Madrid, SPAIN
The implementation of EBUS in Latin America entails challenges related to staff training, equipment acquisition and paperwork for the approval of the procedures by insurers that could decrease its diagnostic performance, compared to that reported by reference centers in developed countries (90% for Linear EBUS and 70% for Radial EBUS). Our objective was to evaluate the diagnostic performance of Linear and Radial EBUS in the Fundacion Neumologica Colombiana and determine the effect of the Rapid On-site Cytological Evaluation (ROSE) on Radial EBUS.
Patients referred for radial or linear EBUS were recruited consecutively. The EBUS was performed under deep sedation with a laryngeal mask by two interventional pulmonologists. Qualitative variables were described with absolute and relative frequencies, quantitative variables with means and standard deviation or median and interquartile ranges depending on whether they had normal distribution or not. The association between qualitative variables was explored using the exact Mid-p test, for the quantitative variables the Student's t-test or the Mann-Whitney U test was used depending on whether they had a normal distribution or not.
Of a total of 558 EBUS included, 65% were Linear and 35% Radial. Patients undergoing linear and radial EBUS in the same anesthetic procedure were 51. The diagnostic yield of linear EBUS was 87% and of radial EBUS was 81%. The most frequent diagnosis was cancer in 54% of the patients and 31% had benign pathologies. ROSE was performed in 51 cases, which improved the diagnostic performance of Radial EBUS from 71% to 88% (P=0.05).
The diagnostic performance of lineal and radial EBUS was good and like that reported in the literature in reference centers in developed countries. The implementation of ROSE allowed increasing the diagnostic performance of the radial EBUS to the same values as the linear EBUS and higher than that reported in the literature.
Disclosure of funding source(s): none