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Endobronchial ultrasonography with a guide sheath (EBUS-GS) improves the accuracy of bronchoscopy. The possibility of differentiating benign from malignant lesions based on EBUS findings may be useful in making the correct diagnosis. The convolutional neural network (CNN) model investigated whether benign or malignant (lung cancer) lesions could be predicted based on EBUS findings. This was an observational, single-center cohort study. Using medical records, patients were divided into benign and malignant groups. We acquired EBUS data for 213 participants. A total of 2,421,360 images were extracted from the learning dataset. We trained and externally validated a CNN algorithm to predict benign or malignant lung lesions. Test was performed using 26,674 images. The dataset was interpreted by four bronchoscopists. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the CNN model for distinguishing benign and malignant lesions were 83.4%, 95.3%, 53.6%, 83.8%, and 82.0%, respectively. For the four bronchoscopists, the accuracy rate was 68.4%, sensitivity was 80%, specificity was 39.6%, PPV was 76.8%, and NPV was 44.2%. The developed EBUS-computer-aided diagnosis system is expected to read EBUS findings that are difficult for clinicians to judge with precision and help differentiate between benign lesions and lung cancers. [ABSTRACT FROM AUTHOR]

A 28‐year‐old man had a cavitary lesion in the upper right lobe with a tree‐in‐bud appearance on chest computed tomography (CT). Diagnostic bronchoscopy was performed. An ultrathin bronchoscope in the right B2aiiβxyy reached the cavity. We filled the cavity with saline under direct bronchoscopic visualization. We suspected a blood vessel was present in the cavity wall based on narrow‐band imaging. Bronchial lavage of the cavity was performed. Next, endobronchial ultrasonography (EBUS) using a guide sheath was performed with a thin bronchoscope. EBUS showed a pulsating blood vessel in the cavity wall. Bronchial lavage collected with ultrathin and thin bronchoscopy revealed Mycobacterium kansasii. Observation of vessels in the wall of a cavitary lesion with ultrathin bronchoscopy and EBUS may be useful for avoiding severe bleeding associated with biopsy of a cavitary lesion. [ABSTRACT FROM AUTHOR]

Background: Endobronchial ultrasonography using a guide sheath (EBUS-GS) is an increasingly common bronchoscopic technique, but currently, no methods have been established to quantitatively evaluate EBUS images of peripheral pulmonary lesions. Objectives: The purpose of this study was to evaluate whether histogram data collected from EBUS-GS images can contribute to the diagnosis of lung cancer. Methods: Histogram-based analyses focusing on the brightness of EBUS images were retrospectively conducted: 60 patients (38 lung cancer; 22 inflammatory diseases), with clear EBUS images were included. For each patient, a 400-pixel region of interest was selected, typically located at a 3- to 5-mm radius from the probe, from recorded EBUS images during bronchoscopy. Histogram height, width, height/width ratio, standard deviation, kurtosis and skewness were investigated as diagnostic indicators. Results: Median histogram height, width, height/width ratio and standard deviation were significantly different between lung cancer and benign lesions (all p < 0.01). With a cutoff value for standard deviation of 10.5, lung cancer could be diagnosed with an accuracy of 81.7%. Other characteristics investigated were inferior when compared to histogram standard deviation. Conclusions: Histogram standard deviation appears to be the most useful characteristic for diagnosing lung cancer using EBUS images. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Endobronchial Ultrasonography (EBUS) can be performed using a balloon, where the probe contacts the object through a balloon filled with medium, or alternatively by a direct contact method where the probe makes direct contact with the object. We established that EBUS using 20 MHz probe shows five layers of the cartilaginous portion of the extrapulmonary bronchus and intrapulmonary bronchus, and three layers of the membranous portion. Pulmonary lesions have an echogenic texture and a sharply defined border due to a strong reflective interface between the aerated lung and the lesion. EBUS for peripheral pulmonary lesions has two main impacts in bronchoscopic diagnosis. One impact is to analyze the internal structures of peripheral pulmonary lesions, and another impact is to detect the location of peripheral pulmonary lesions during bronchoscopy. EBUS using a guide sheath (EBUS-GS) provides the pathway to peripheral pulmonary lesions. One advantage of EBUS-GS lies in the repeatability of access to the bronchial lesion for sampling. Another advantage of EBUS-GS lies in its ability to protect against bleeding into proximal bronchus from the biopsy site. The final advantage of EBUS-GS is the ability to obtain short-axis bronchial views of peripheral pulmonary lesions. For the successful EBUS with transbronchial needle aspiration EBUS-TBNA, we clarify some methods of puncturing between cartilage and obtaining adequate specimens. [Copyright &y& Elsevier]

The article investigates whether artificial neural networks (ANNs) could diagnose pathology of lymph nodes by feeding B-mode images from convex-type echobronchoscopy by researchers from Japan. It evaluates 91 patients who had undergone endobronchial ultrasonography transbronchial needle aspiration. Diagnostic results revealed that assessment of B-mode images by ANNs may offer useful basis for automatic diagnostic.

The article presents information on a study which analyzes the factors related to the diagnostic yield of transbronchial biopsy (TBB) with endobronchial ultrasonography with a guide sheath (EBUS-GS) in patients with small peripheral pulmonary lesions (PPLs). The results say that position of the probe affects the diagnostic yield of TBB in small PPLs.

The article presents a study on endobronchial ultrasonography (EBUS) guidance for transbronchial needle aspiration (TBNA) using a double-channel bronchoscope (EBUS-D). A randomized, comparative prospective study was conducted to 55 patients between January 2000 and August 2003. The study concluded that EBUS-D is useful for diagnosing intrathoracic lymphadenopathy, and the obtained specimen with real-time confirmation of the needle is directly proportional to an accurate diagnosis.

Study objective: To assess the ability of endobronchial ultrasonography (EBUS) using a guide sheath (EBUS-GS) to diagnose peripheral pulmonary lesions. Method: We devised a technique for EBUS-GS covering a miniature probe, and 150 lesions were evaluated in a prospective open study. In this procedure, the probe covered by a guide sheath is introduced into the lesion via the working channel of a bronchoscope. The probe is withdrawn, while the guide sheath is left in situ. A brush or biopsy forceps is introduced through the guide sheath into the lesion. Results: One hundred sixteen of 150 EBUS-GS procedures (77%) were diagnostic. Cases in which the probe was located within the lesion had a significantly higher diagnostic yield (105 of 121 cases, 87%) than when the probe was located adjacent to it (8 of 19 cases, 42%) [p < 0.0001, χ²]. The diagnostic yield from EBUS-GS in lesions ≤ 10 mm (16 of 21 lesions, 76%), >10 to ≤ 15 mm (19 of 25 lesions, 76%; p = 0.99, χ ²), >15 to ≤ 20 mm (23 of 35 lesions, 66%; p = 0.41, χ ²), and > 20 to ≤ 30 mm (33 of 43 lesions, 77%; p = 0.96, χ ²) were similar, demonstrating the efficacy of EBUS-GS even in lesions ≤ 10 mm in diameter. In 54 of 81 lesions ≤ 20 mm, fluoroscopy was not able to confirm whether the forceps reached the lesion. However, the yield was the same with (67%, 18 of 27 lesions) and without (74%, 40 of 54 lesions) successful fluoroscopy (p = 0.96, χ ²). Moderate bleeding occurred in two patients (1%); there were no other complications. Conclusions: EBUS-GS is a useful method for collecting samples from peripheral pulmonary lesions, even those too small to be visualized under fluoroscopy. [ABSTRACT FROM AUTHOR]

THE EVALUATION OF ULTRA-THIN BRONCHOSCOPY IN THE DIAGNOSIS OF PERIPHERAL LUNG LESIONS AND THE USEFULNESS OF ENDOBRONCHIAL ULTRASONOGRAPHY USING A GUIDE SHEATH IN THIN BRONCHOSCOPY B PURPOSE: b We evaluated the application of ultra-thin bronchoscopy in the diagnosis of peripheral lung lesions and examined the usefulness of endobronchial ultrasonography using a guide sheath (EBUS-GS) in thin bronchoscopy. B CLINICAL IMPLICATIONS: b We could directly observe peripheral lung lesions with an ultra-thin bronchoscope following the injection saline, and we could therefore identify the accurate route to the peripheral lesion. [Extracted from the article]

Relapsing polychondritis (RP) with tracheobronchial involvement has a poor prognosis, and a delay in diagnosis increases morbidity and mortality; however, the diagnosis is difficult to make. Endobronchial ultrasonography (EBUS) revealed changes in the tracheobronchial cartilage in two patients who met the criteria for RP, and facilitated the diagnosis. In these cases, EBUS revealed a poorly defined bronchial wall structure with two patterns of cartilaginous damage: fragmentation and edema. These eases were successfully treated by the implantation of nitinol stents, the sizes of which were determined by EBUS. EBUS was found to be useful in the diagnosis and treatment of RP. [ABSTRACT FROM AUTHOR]