Endobronchial Ultrasound (EBUS)
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Endobronchial ultrasound (EBUS) offers a more precise way of assessing a patient's lymph nodes and determining if lung cancer has spread to other parts of the body.
With lung and esophageal cancers, treatment decisions and the patient's prognosis is directly related to the extent of the disease, or the "stage" of the cancer.
Because malignancies in the chest can easily spread through the body via lymph nodes, the initial "staging" of the cancer is impacted dramatically by the discovery that tumors have invaded the lymph nodes. Endobronchial ultrasound (EBUS) allows for for complete staging of the medistinum (the area between the lungs) through a less invasive approach.
Endobronchial Ultrasound and Accurate Cancer Staging
Lung cancer is typically diagnosed after it has already spread, and long-term prognosis for patients is usually poor. But with the innovation of endobronchial ultrasound and its ability to accurately show the cancer stage, patients with early-stage lung cancer may avoid more extensive surgery.
With less-invasive procedures, such patients may then leave the hospital sooner and use less pain medication as they recover.
Another advantage of EBUS is that patients who may benefit from surgery will not be deemed poor surgical candidates due to potentially less accurate information from conventional CT and PET scans.
Endobronchial Ultrasound Procedure
In an endobronchial ultrasound, the patient is placed under conscious sedation and a small bronchoscope with a special ultrasound at its tip is passed through the patient's mouth down into the windpipe. The scope has a small instrument at its tip called a transducer, which can be pointed in different directions to produce images of lymph nodes and other structures in the area between the lungs, called the Mediastinum.
Using the probe's detailed images, the physician is able to assess whether the cancer has spread within the windpipe and nodes on either side.
The EBUS technology is a hybrid, employing ultrasound guidance with a bronchoscope, enabling real-time transbronchial needle aspiration to be performed. This combination aids in the diagnosis and staging of lung cancer. In clinical trials, many patients evaluated with EBUS were able to forego more invasive procedures, such as mediastinoscopy, thoracoscopy or thoracotomy.
Biopsies Using Endobronchial Ultrasound
Using EBUS, biopsies are performed through the trachea using ultrasound rather than surgical incisions that must be made in other, more invasive procedures. The EBUS procedure is usually completed in less than half an hour.
Endobronchial ultrasound allows the physician to look in areas of the chest where it's traditionally difficult to biopsy. If suspicious areas are seen – such as enlarged lymph nodes – a hollow needle can be passed through the bronchoscope and guided by ultrasound into the abnormal structures to obtain a biopsy.
In many cases, EBUS offers better sensitivity and specificity without the need to make an incision.