Tal Klatchko, D.O.

Pulmonary & Critical Care
Roper-St. Francis Hospital
Charleston, South Carolina

Endobronchial Ultrasound

Endobronchial Ultrasound (EBUS) is a relatively new procedure used in the diagnosis of lung cancer, infections, and other diseases causing enlarged lymph nodes in the chest. Currently, only a few centers offer EBUS, a minimally invasive procedure that has proven highly effective.

Why is it used?
The EBUS procedure allows physicians to perform a technique known as transbronchial needle aspiration (TBNA) to obtain tissue or fluid samples from the lungs and surrounding lymph nodes without conventional surgery. The samples can be used for diagnosing and staging lung cancer, detecting infections, and identifying inflammatory diseases that affect the lungs, such as sarcoidosis.

What makes EBUS different?
During the conventional diagnostic procedure, surgery known as mediatinoscopy is performed to provide access to the chest. A small incision is made in the neck just above the breastbone or next to the breastbone. Next, a thin scope, called a mediastinoscope, is inserted through the opening to provide access to the lungs and surrounding lymph nodes. Tissue or fluid is then collected via biopsy.

During endobronchial ultrasound, however, the physician can perform needle aspiration on lymph nodes using a bronchoscope inserted through the mouth. For the EBUS procedure, a special endoscope fitted with an ultrasound processor and a fine-gauge aspiration needle is guided through the patient’s trachea. No incisions are necessary.

Benefits of EBUS
The ultrasound display provides real-time imaging of the surface of the airways, blood vessels, lungs and lymph nodes. The improved images allow the physician to easily view difficult-to-reach areas and to access more, and smaller, lymph nodes for biopsy with the aspiration needle than through conventional mediatinoscopy.

In addition, the accuracy and speed of the EBUS procedure lends itself to rapid onsite pathologic evaluation. Pathologists in the operating room can process and examine biopsy samples as they are obtained, and can request additional samples to be taken immediately if needed.

EBUS is performed under moderate sedation or general anesthesia. EBUS patients recover quickly and can generally go home the same day.