Table 1.
Characteristics of the included studies
| Study details [Ref.] Journal | Previous tests to obtain a biopsy-based diagnosis | Mean age (range), years | Male, % | Type of test | Rapid on-site cytological evaluation | Needle type | Number of needle passes (range) | Procedure length, min | Tumor size, mm | Reference standard in patients with a nondiagnostic or nonmalignant EUS-FNA | EUS-FNA-induced complications |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Varadarajulu, 2004, USA [19] Gastrointest Endosc | All patients had a nondiagnostic conventional bronchoscopy or CT-guided biopsy | 63 (41 – 77) | 61 | EUS | Available | 22-G | Mean: 2 (1 – 6) | NR | Mean (long axis): 46 (range: 24 – 85) | Not applicable (all patients had a malignancy diagnosed with EUS-FNA) | None |
| Annema, 2005, The Netherlands [20] Lung Cancer | All patients had a nondiagnostic conventional bronchoscopy | 62 (43 – 81) | 63 | EUS | Available | 22-G | Mean: 2 (1 – 6) | NR | Mean: 45 (range: 15 – 90) | Surgical-pathological verification | None |
| Paquin, 2005, Canada [21] Gastrointest Endosc | NR | 63 (20 – 80) | 80 | EUS | Available | 22-G | Mean: 4 (1 – 5) | NR | Mean/median: NR (range: 20 × 24 to 45 × 47) | Histology (no details) | None |
| Sawhney, 2006a, USA [22] Gastrointest Endosc | Some patients had a nondiagnostic CT-guided biopsy, conventional bronchoscopy, or thoracocentesis | 67 (43 – 82) | 97 | EUS | Available | NR | Median: 5 (3 – 8) | NR | Median (short axis): 40 (range: NR) | – Surgical-pathological verification – Bronchoscopy – CT-guided biopsy – Clinical follow-up (≥1 year) |
– Self-limited severe chest pain with admission (n = 1) – Self-limited hemoptysis (n = 1) |
| Hernandez, 2007, USA [23] J Clin Gastroenterol | NR | 66 (48 – 81) | 47 | EUS | Available | 22- or 25-G | Mean: 3 (2 – 4) | Median: 21 (range: 15 – 45) | Median: 50 × 40 (range: 20 – 120 × 20 – 90) | Not applicable (all patients had a malignancy diagnosed with EUS-FNA) | Hemoptysis with aspiration pneumonia (n = 1) |
| Nguyen, 2011b, Australia [24] ANZ J Surg | NR | 64 (27 – 85) | 64 | EUS | NR | 19- or 22-G | NR | NR | NR | – Surgical-pathological verification – Clinical follow-up |
NR |
| Songür, 2011c, Turkey [25] Turk J Gastroenterol | All patients had a nondiagnostic conventional bronchoscopy or CT-guided biopsy | 58 (32 – 78) | 67 | EUS | NR | 19- or 22-G | Mean: 3.3 (3 – 5) | Mean: 27 (SD: 4.6) | Mean (diameter): 35 (range: 28 – 47) | – Surgical-pathological verification – Clinical follow-up |
NR |
| Assisi, 2013, Italy [26] Dig Liver Dis | NR | NR | NR | EUS | NR | NR | NR | NR | NR | Not applicable (all patients had a malignancy diagnosed with EUS-FNA) | NR |
| Vazquez-Sequeiros, 2013, Spain [27] Diagn Ther Endosc | Some patients had a nondiagnostic conventional bronchoscopy or CT-guided biopsy (EBUS was not available) | 68 (61 – 82) | 78 | EUS | Available | 25-G | Median: 1 (1 – 3) | NR | Median (long axis): 26 (range: 12 – 65) | – Surgical-pathological verification – Mediastinoscopy – Thoracoscopy – Percutaneous biopsy – Autopsy – Clinical follow-up (≥1 year) |
Pneumothorax (n = 1) |
| Nasir, 2014, Canada [28] J Thorac Cardiovasc Surg | Some patients had a nondiagnostic “traditional technique for lung nodule biopsy” | 63 (39 – 83) | 44 | EUS | Unavailable | 22-G | Average: 2 – 4 | NR | Mean (long axis): 49 (range: 8 – 110) | Surgical-pathological verification | None |
| Steinfort, 2016 Australia [29] J Bronchology Interv Pulmonol | None of the patients had received a previous test to obtain a biopsy-based diagnosis | NR | NR | EUS-B | Available | 22-G | NR | NR | Mean: 36 (SD 16) | Surgical-pathological verification | Pneumothorax (n = 1) |
NR, not reported; SD, standard deviation; EUS-FNA, endoscopic ultrasound-guided fine-needle aspiration; EUS-B, EUS with an EBUS-scope; CT, computed tomography.
a
Age and gender data apply to the complete cohort of 66 patients; however, 47 of these were excluded from this review because EUS-FNA did not target an intrapulmonary tumor.
b
Data apply to the complete cohort of 148 patients; however, 124 of these were excluded from this review because EUS-FNA did not target an intrapulmonary tumor.
c
Data apply to the complete cohort of 57 patients; however, 35 of these were excluded from this review because EUS-FNA did not target an intrapulmonary tumor.