• Alex Chee, David R Stather, Paul Maceachern, Simon Martel, Antoine Delage, Mathieu Simon, Elaine Dumoulin, and Alain Tremblay.
• University of Calgary, Calgary, Alberta, Canada. cheec@ucalgary.ca
• Respirology. 2013 Jul 1;18(5):784-9.

Background And ObjectiveThis study aimed to investigate the diagnostic utility of peripheral endobronchial ultrasound (pEBUS) followed by as-needed electromagnetic navigation bronchoscopy (ENB) for sampling peripheral lung nodules.MethodsThe study was a single-arm, prospective cohort study of patients with peripheral lung nodules. Peripheral lung lesion localization was initially performed using a pEBUS probe with guide sheath. If localization failed with pEBUS alone, ENB was used to help identify the lesion. Transbronchial biopsy, bronchial brush, transbronchial needle aspiration and bronchial washings were performed.ResultsSixty patients were enrolled with average lesion size of 27 mm and mean pleural distance of 20 mm. Lesions were found with pEBUS alone in 75% of cases. The addition of ENB improved lesion localization to 93%. However, diagnostic yield for pEBUS alone and pEBUS with ENB were 43% and 50%, respectively. Factors predicting need for ENB use included smaller lesion size and absence of an air bronchus sign on computed tomography.ConclusionsENB improves localization of lung lesions after unsuccessful pEBUS but is often not sufficient to ensure confirmation of a specific diagnosis. Technical improvements in sampling methods could improve the diagnostic yield.© 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

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