Endobronchial ultrasound - A new perspective in bronchoscopy

Aim: Since the view of the endoscopist is restricted and radiological procedures are unreliable in the diagnosis of mediastinal disease, we investigated endobronchial ultrasound in a preliminary clinical study. Methods: Two of the systems tested, Olympus and Sonotron (CVIS), proved to be applicable after some modifications. They were tested in a phantom, in resection specimens acid in 500 bronchoscopies. Results: In tumour staging infiltration of the bronchial wall and parabronchial structures could be assessed. Lymph nodes could be detected down to 3 mm, but not even by in vitro examination of 84 resected lymph nodes could we find reliable signs for malignancy. Infiltration of the bronchial wall and involvement of large vessels by mediastinal masses was frequently diagnosed. Involvement of the airways by vascular anomalies, pleural effusion or solid masses could be differentiated. Conclusions: In view of the fact that the procedure costs around $20, it seems feasible and we are currently examining its value in a prospective study.