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The value of endoscopic ultrasound after bronchoscopy to diagnose thoracic sarcoidosis

Kurt Tournoy UGent, A Bolly, JG Aerts, P Pierard, R De Pauw, D Leduc, A Leloup, T Pieters, H Slabbynck, A Janssens, et al. (2010) EUROPEAN RESPIRATORY JOURNAL. 35(6). p.1329-1335
abstract
Abstract: A clinicoradiological presentation of thoracic sarcoidosis requires histopathology in order to establish the diagnosis. Flexible bronchoscopy has a reasonable diagnostic yield and is the procedure of first choice for diagnosis. Endoscopic ultrasound (endoscopic ultrasound-guided fine needle aspiration/endobronchial ultrasound-guided transbronchial needle aspiration) can help in the diagnosis of sarcoidosis. An implementation strategy of endoscopic ultrasound for the diagnosis of sarcoidosis following negative flexible bronchoscopy results was examined prospectively in 15 clinics. A total of 137 patients (92 males; median age 43 yrs) were included, and sarcoidosis was found in 115 (84%). Alternative diagnoses were tuberculosis, lymphangitis carcinomatosa, pneumoconiosis and alveolitis. All patients were sent for flexible bronchoscopy, which was performed in 121 (88%), resulting in a definite diagnosis in 57 (42%). A total of 80 patients were sent for endoscopic ultrasound, which could be performed in 72 (90%), yielding a definite diagnosis in 47 (59%). Endoscopic ultrasound following negative flexible bronchoscopy avoided a surgical procedure in 47 out of 80 patients. The sensitivity of flexible bronchoscopy for sarcoidosis was 45% (95% confidence interval 35-54%), but 62% (50-72%) if biopsy specimens were taken. The sensitivity of endoscopic ultrasound following negative flexible bronchoscopy results was 71% (58-82%). With this strategy, 97 out of 115 (84% (76-90%)) of proven sarcoidosis was diagnosed using endoscopy. This large prospective implementation study (trial number NCT00888212; ClinicalTrials.gov) shows that endoscopic ultrasound is valuable for diagnosing sarcoidosis after negative flexible bronchoscopy results.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
TRANSBRONCHIAL NEEDLE ASPIRATION, CELL LUNG-CANCER, sarcoidosis, mediastinoscopy, endoscopic ultrasound, endoscopic ultrasound-guided fine needle aspiration, endobronchial ultrasound-guided transbronchial needle aspiration, Bronchoscopy, ENDOBRONCHIAL ULTRASOUND, BIOPSY, MEDIASTINOSCOPY, GUIDELINES
journal title
EUROPEAN RESPIRATORY JOURNAL
Eur. Resp. J.
volume
35
issue
6
pages
1329 - 1335
Web of Science type
Article
Web of Science id
000278194000021
JCR category
RESPIRATORY SYSTEM
JCR impact factor
5.922 (2010)
JCR rank
4/45 (2010)
JCR quartile
1 (2010)
ISSN
0903-1936
DOI
10.1183/09031936.00111509
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1087520
handle
http://hdl.handle.net/1854/LU-1087520
date created
2010-12-15 09:50:09
date last changed
2016-12-19 15:46:18
@article{1087520,
  abstract     = {Abstract: A clinicoradiological presentation of thoracic sarcoidosis requires histopathology in order to establish the diagnosis. Flexible bronchoscopy has a reasonable diagnostic yield and is the procedure of first choice for diagnosis. Endoscopic ultrasound (endoscopic ultrasound-guided fine needle aspiration/endobronchial ultrasound-guided transbronchial needle aspiration) can help in the diagnosis of sarcoidosis. 
An implementation strategy of endoscopic ultrasound for the diagnosis of sarcoidosis following negative flexible bronchoscopy results was examined prospectively in 15 clinics.
A total of 137 patients (92 males; median age 43 yrs) were included, and sarcoidosis was found in 115 (84\%). Alternative diagnoses were tuberculosis, lymphangitis carcinomatosa, pneumoconiosis and alveolitis. All patients were sent for flexible bronchoscopy, which was performed in 121 (88\%), resulting in a definite diagnosis in 57 (42\%). A total of 80 patients were sent for endoscopic ultrasound, which could be performed in 72 (90\%), yielding a definite diagnosis in 47 (59\%). Endoscopic ultrasound following negative flexible bronchoscopy avoided a surgical procedure in 47 out of 80 patients. The sensitivity of flexible bronchoscopy for sarcoidosis was 45\% (95\% confidence interval 35-54\%), but 62\% (50-72\%) if biopsy specimens were taken. The sensitivity of endoscopic ultrasound following negative flexible bronchoscopy results was 71\% (58-82\%). With this strategy, 97 out of 115 (84\% (76-90\%)) of proven sarcoidosis was diagnosed using endoscopy.
This large prospective implementation study (trial number NCT00888212; ClinicalTrials.gov) shows that endoscopic ultrasound is valuable for diagnosing sarcoidosis after negative flexible bronchoscopy results.},
  author       = {Tournoy, Kurt and Bolly, A and Aerts, JG and Pierard, P and De Pauw, R and Leduc, D and Leloup, A and Pieters, T and Slabbynck, H and Janssens, A and Carron, K and Schrevens, L and Pat, K and De Keukeleire, T and Dooms, C},
  issn         = {0903-1936},
  journal      = {EUROPEAN RESPIRATORY JOURNAL},
  keyword      = {TRANSBRONCHIAL NEEDLE ASPIRATION,CELL LUNG-CANCER,sarcoidosis,mediastinoscopy,endoscopic ultrasound,endoscopic ultrasound-guided fine needle aspiration,endobronchial ultrasound-guided transbronchial needle aspiration,Bronchoscopy,ENDOBRONCHIAL ULTRASOUND,BIOPSY,MEDIASTINOSCOPY,GUIDELINES},
  language     = {eng},
  number       = {6},
  pages        = {1329--1335},
  title        = {The value of endoscopic ultrasound after bronchoscopy to diagnose thoracic sarcoidosis},
  url          = {http://dx.doi.org/10.1183/09031936.00111509},
  volume       = {35},
  year         = {2010},
}

Chicago
Tournoy, Kurt, A Bolly, JG Aerts, P Pierard, R De Pauw, D Leduc, A Leloup, et al. 2010. “The Value of Endoscopic Ultrasound After Bronchoscopy to Diagnose Thoracic Sarcoidosis.” European Respiratory Journal 35 (6): 1329–1335.
APA
Tournoy, K., Bolly, A., Aerts, J., Pierard, P., De Pauw, R., Leduc, D., Leloup, A., et al. (2010). The value of endoscopic ultrasound after bronchoscopy to diagnose thoracic sarcoidosis. EUROPEAN RESPIRATORY JOURNAL, 35(6), 1329–1335.
Vancouver
1.
Tournoy K, Bolly A, Aerts J, Pierard P, De Pauw R, Leduc D, et al. The value of endoscopic ultrasound after bronchoscopy to diagnose thoracic sarcoidosis. EUROPEAN RESPIRATORY JOURNAL. 2010;35(6):1329–35.
MLA
Tournoy, Kurt, A Bolly, JG Aerts, et al. “The Value of Endoscopic Ultrasound After Bronchoscopy to Diagnose Thoracic Sarcoidosis.” EUROPEAN RESPIRATORY JOURNAL 35.6 (2010): 1329–1335. Print.