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Semin Respir Crit Care Med 2008; 29(4): 453-464
DOI: 10.1055/s-2008-1081287
© Thieme Medical Publishers
DOI: 10.1055/s-2008-1081287
Ultrasound-Guided Endobronchial, Endoscopic, and Transthoracic Biopsy
Further Information
Publication History
Publication Date:
23 July 2008 (online)
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ABSTRACT
Advances in ultrasound technology coupled with reduced costs have provided the chest physician with novel approaches for evaluating lung and pleural diseases. This review examines the evidence for the use of three ultrasonic techniques pertinent to pulmonary disease: endobronchial ultrasound, endoscopic ultrasound, and transthoracic ultrasound.
KEYWORDS
Endobronchial ultrasound - bronchoscopy - endoscopic ultrasound - lung cancer - transthoracic ultrasound
REFERENCES
- 1 Hürter T, Hanrath P. Endobronchial sonography: feasibility and preliminary results. Thorax. 1992; 47 565-567
- 2 Alberts W M. Introduction: diagnosis and management of lung cancer. ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007; 132(3 Suppl) 20S-22S
- 3 Kennedy T C, McWilliams A, Edell E et al.. Bronchial intraepithelial neoplasia/early central airways lung cancer. ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007; 132(3 Suppl) 221S-233S
-
4 Becker H D, Herth F.
Endobronchial ultrasound of the airways and the mediastinum . In: Bolliger CT, Mathur PN Interventional Bronchoscopy. Basel; Karger 2000: 80-93 Progress in Respiratory Research, vol 30 - 5 Kurimoto N, Murayama M, Yoshioka S, Nishisaka T, Inai K, Dohi K. Assessment of usefulness of endobronchial ultrasonography in determination of depth of tracheobronchial tumor invasion. Chest. 1999; 115 1500-1506
- 6 Miyazu Y, Miyazawa T, Kurimoto N, Iwamoto Y, Kanoh K, Kohno N. Endobronchial ultrasonography in the assessment of centrally located early-stage lung cancer before photodynamic therapy. Am J Respir Crit Care Med. 2002; 165 832-837
- 7 Detterbeck F C, Jantz M A, Wallace M, Vansteenkiste J, Silvestri G A. American College of Chest Physicians . Invasive mediastinal staging of lung cancer. ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007; 132(3 Suppl) 202S-220S
- 8 Mountain C F, Dresler C M. Regional lymph node classification for lung cancer staging. Chest. 1997; 111 1718-1723
- 9 Little A G, Rusch V W, Bonner J A et al.. Patterns of surgical care of lung cancer patients. Ann Thorac Surg. 2005; 80 2051-2056
- 10 Holty J E, Kuschner W G, Gould M K. Accuracy of transbronchial needle aspiration for mediastinal staging of non-small cell lung cancer: a meta-analysis. Thorax. 2005; 60 949-955
- 11 Herth F J, Becker H D, Ernst A. Ultrasound-guided transbronchial needle aspiration: an experience in 242 patients. Chest. 2003; 123 604-607
- 12 Herth F, Becker H D, Ernst A. Conventional vs endobronchial ultrasound-guided transbronchial needle aspiration: a randomized trial. Chest. 2004; 125 322-325
- 13 Herth F J, Lunn W, Eberhardt R et al.. Transbronchial versus transesophageal ultrasound-guided aspiration of enlarged mediastinal lymph nodes. Am J Respir Crit Care Med. 2005; 171 1164-1167
- 14 Schreiber G, McCrory D C. Performance characteristics of different modalities for diagnosis of suspected lung cancer: summary of published evidence. Chest. 2003; 123(1 Suppl) 115S-128S
- 15 Baaklini W A, Reinoso M A, Gorin A B, Sharafkaneh A, Manian P. Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest. 2000; 117 1049-1054
- 16 Wahidi M M, Govert J A, Goudar R K, Gould M K, McCrory D C. American College of Chest Physicians . Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer? ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007; 132(3 Suppl) 94S-107S
- 17 Kurimoto N, Murayama M, Yoshioka S, Nishisaka T. Analysis of the internal structure of peripheral pulmonary lesions using endobronchial ultrasonography. Chest. 2002; 122 1887-1894
- 18 Kuo C H, Lin S M, Chen H C, Chou C L, Yu C T, Kuo H P. Diagnosis of peripheral lung cancer with three echoic features via endobronchial ultrasound. Chest. 2007; 132 922-929
- 19 Herth F J, Ernst A, Becker H D. Endobronchial ultrasound-guided transbronchial lung biopsy in solitary pulmonary nodules and peripheral lesions. Eur Respir J. 2002; 20 972-974
- 20 Kurimoto N, Miyazawa T, Okimasa S et al.. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically. Chest. 2004; 126 959-965
- 21 Kikuchi E, Yamazaki K, Sukoh N et al.. Endobronchial ultrasonography with guide-sheath for peripheral pulmonary lesions. Eur Respir J. 2004; 24 533-537
- 22 Yang M C, Liu W T, Wang C H et al.. Diagnostic value of endobronchial ultrasound-guided transbronchial lung biopsy in peripheral lung cancers. J Formos Med Assoc. 2004; 103 124-129
- 23 Asahina H, Yamazaki K, Onodera Y et al.. Transbronchial biopsy using endobronchial ultrasonography with a guide sheath and virtual bronchoscopic navigation. Chest. 2005; 128 1761-1765
- 24 Paone G, Nicastri E, Lucantoni G et al.. Endobronchial ultrasound-driven biopsy in the diagnosis of peripheral lung lesions. Chest. 2005; 128 3551-3557
- 25 Herth F J, Eberhardt R, Becker H D, Ernst A. Endobronchial ultrasound-guided transbronchial lung biopsy in fluoroscopically invisible solitary pulmonary nodules: a prospective trial. Chest. 2006; 129 147-150
- 26 Eberhardt R, Anantham D, Ernst A, Feller-Kopman D, Herth F. Multimodality bronchoscopic diagnosis of peripheral lung lesions: a randomized controlled trial. Am J Respir Crit Care Med. 2007; 176 36-41
- 27 Herth F, Ernst A, Schulz M, Becker H. Endobronchial ultrasound reliably differentiates between airway infiltration and compression by tumor. Chest. 2003; 123 458-462
- 28 Wakamatsu T, Tsushima K, Yasuo M et al.. Usefulness of preoperative endobronchial ultrasound for airway invasion around the trachea: esophageal cancer and thyroid cancer. Respiration. 2006; 73 651-657
- 29 Irani S, Hess T, Hofer M et al.. Endobronchial ultrasonography for the quantitative assessment of bronchial mural structures in lung transplant recipients. Chest. 2006; 129 349-355
- 30 Herth F, Becker H D, LoCicero III J, Ernst A. Endobronchial ultrasound in therapeutic bronchoscopy. Eur Respir J. 2002; 20 118-121
- 31 Sarkiss M, Kennedy M, Riedel B et al.. Anesthesia technique for endobronchial ultrasound-guided fine needle aspiration of mediastinal lymph node. J Cardiothorac Vasc Anesth. 2007; 21 892-896
- 32 Lee H S, Lee G K, Zo J I, Hwangbo B. Real-time endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) in mediastinal staging of NSCLC: how many aspirates per target lymph node?: a preliminary report [abstract]. Am J Respir Crit Care Med. 2007; 175 A619
- 33 Yasufuku K, Chhajed P N, Sekine Y et al.. Endobronchial ultrasound using a new convex probe: a preliminary study on surgically resected specimens. Oncol Rep. 2004; 11 293-296
- 34 Krasnik M, Vilmann P, Larsen S S, Jacobsen G K. Preliminary experience with a new method of endoscopic transbronchial real time ultrasound guided biopsy for diagnosis of mediastinal and hilar lesions. Thorax. 2003; 58 1083-1086
- 35 Yasufuku K, Chiyo M, Sekine Y et al.. Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest. 2004; 126 122-128
- 36 Herth F J, Eberhardt R, Vilmann P et al.. Real-time endobronchial ultrasound guided transbronchial needle aspiration for sampling mediastinal lymph nodes. Thorax. 2006; 61 795-798
- 37 Kennedy M P, Jimenez C A, Morice R C et al.. Yield of endobronchial ultrasound guided transbronchial needle aspiration in the diagnosis of mediastinal lymphadenopathy. Chest. 2007; 132 S591
- 38 Yasufuku K, Chiyo M, Koh E et al.. Endobronchial ultrasound guided transbronchial needle aspiration for staging of lung cancer. Lung Cancer. 2005; 50 347-354
- 39 Herth F J, Ernst A, Eberhardt R et al.. Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes in the radiologically normal mediastinum. Eur Respir J. 2006; 28 910-914
- 40 Yasufuku K, Nakajima T, Motoori K et al.. Comparison of endobronchial ultrasound, positron emission tomography, and CT for lymph node staging of lung cancer. Chest. 2006; 130 710-718
- 41 Vilmann P, Krasnik M, Larsen S S, Jacobsen G K, Clementsen P. Transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy: a combined approach in the evaluation of mediastinal lesions. Endoscopy. 2005; 37 833-839
- 42 Rintoul R C, Skwarski K M, Murchison J T, Wallace W A, Walker W S, Penman I D. Endobronchial and endoscopic ultrasound-guided real-time fine-needle aspiration for mediastinal staging. Eur Respir J. 2005; 25 416-421
- 43 Annema J T, Veselic M, Rabe K T. Real-time endobronchial ultrasound guided tbna in (suspected) lung cancer [abstract]. Am J Respir Crit Care Med. 2006; 3 A609
- 44 Rintoul R C, Buttery R C, Stewart S, Wallace R A, Walker W S, Swarski K M. Endobronchial ultrasound guided transbronchial needle aspiration can avoid the need for mediastinoscopy in lung cancer staging [abstract]. Am J Respir Crit Care Med. 2006; 3 A609
- 45 Annema J T, Versteegh M I, Veselic M, Rabe K T. Mediastinal Staging of Lung Cancer: EBUS -TBNA vs Mediastinoscopy [abstract]. Am J Respir Crit Care Med. 2007; 179 A619
- 46 Philippe E. Pierard, Jean Faber, Olivier Bauwens, Thierry Prigogine, Bich Nguyen, Michelle Dusart, and Vincent Ninane . Evaluation of a new tool in mediastinal staging of lung cancer. Real-time guided needle aspiration using endobronchial ultrasound (EBUS-NA). Chest. 2006; 130 S146
- 47 Skwarski M K, McCafferty J, Wood F et al.. Minimally invasive staging in lung cancer by real-time endobronchial ultrasound FNA (EBUS). Chest. 2007; 130 S591-S592
- 48 Robinson L A, Ruckdeschel J C, Wagner Jr H, Stevens C W. Treatment of non-small cell lung cancer–stage III A: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007; 132(3 Suppl) 243S-265S
- 49 Herth F, Yasufuku K, Eberhardt R et al.. EBUS-TBNA for mediastinal restaging after induction chemotherapy for non-small cell lung cancer. Chest. 2007; 130 S466
- 50 Wong M, Yasufuku K, Nakajima T et al.. Endobronchial ultrasound: new insight for the diagnosis of sarcoidosis. Eur Respir J. 2007; 29 1182-1186
- 51 Garwood S, Judson M A, Silvestri G, Hoda R, Fraig M, Doelken P. Endobronchial ultrasound for the diagnosis of pulmonary sarcoidosis. Chest. 2007; 132 1298-1304
- 52 Kennedy M P, Jimenez C A, Morice R C, Eapen G A. Is endobronchial ultrasound additive to routine bronchoscopy in diagnosing sarcoidosis?. Eur Respir J. 2007; 30 601-602
- 53 Kennedy M P, Jimenez C A, Bruzzi J F et al.. Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of lymphoma. Thorax. 2008; 63 360-365
- 54 Nakajima T, Yasufuku K, Shibuya K, Fujisawa T. Endobronchial ultrasound-guided transbronchial needle aspiration for the treatment of central airway stenosis caused by a mediastinal cyst. Eur J Cardiothorac Surg. 2007; 32 538-540
- 55 Nakajima T, Yasufuku K, Suzuki M et al.. Histological diagnosis of spinal chondrosarcoma by endobronchial ultrasound-guided transbronchial needle aspiration. Respirology. 2007; 12 308-310
- 56 Kennedy M P, Morice R C, Jimenez C A, Eapen G A. Endobronchial ultrasound appearance of pulmonary artery thrombus in a patient with thymic carcinoma. J Thorac Oncol. 2007; 2 862
- 57 Nakajima T, Yasufuku K, Suzuki M et al.. Assessment of epidermal growth factor receptor mutation by endobronchial ultrasound-guided transbronchial needle aspiration. Chest. 2007; 132 597-602
- 58 Wiersema M J, Vilmann P, Giovannini M, Chang K J, Wiersema L M. Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology. 1997; 112 1087-1095
- 59 Silvestri G A, Hoffman B J, Bhutani M S et al.. Endoscopic ultrasound with fine-needle aspiration in the diagnosis and staging of lung cancer. Ann Thorac Surg. 1996; 61 1441-1445
- 60 Gress F G, Hawes R H, Savides T J, Ikenberry S O, Lehman G A. Endoscopic ultrasound-guided fine-needle aspiration biopsy using linear array and radial scanning endosonography. Gastrointest Endosc. 1997; 45 243-250
- 61 Williams D B, Sahai A V, Aabakken L et al.. Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Gut. 1999; 44 720-726
- 62 Wallace M B, Silvestri G A, Sahai A V et al.. Endoscopic ultrasound-guided fine needle aspiration for staging patients with carcinoma of the lung. Ann Thorac Surg. 2001; 72 1861-1867
- 63 Wiersema M J, Vazquez-Sequeiros E, Wiersema L M. Evaluation of mediastinal lymphadenopathy with endoscopic US-guided fine-needle aspiration biopsy. Radiology. 2001; 219 252-257
- 64 Larsen S S, Krasnik M, Vilmann P et al.. Endoscopic ultrasound guided biopsy of mediastinal lesions has a major impact on patient management. Thorax. 2002; 57 98-103
- 65 Fritscher-Ravens A, Bohuslavizki K H, Brandt L et al.. Mediastinal lymph node involvement in potentially resectable lung cancer: comparison of CT, positron emission tomography, and endoscopic ultrasonography with and without fine-needle aspiration. Chest. 2003; 123 442-451
- 66 Annema J T, Hoekstra O S, Smit E F, Veselic M, Versteegh M I, Rabe K F. Towards a minimally invasive staging strategy in NSCLC: analysis of PET positive mediastinal lesions by EUS-FNA. Lung Cancer. 2004; 44 53-60
- 67 Kramer H, van Putten J W, Post W J et al.. Oesophageal endoscopic ultrasound with fine needle aspiration improves and simplifies the staging of lung cancer. Thorax. 2004; 59 596-601
- 68 Savides T J, Perricone A. Impact of EUS-guided FNA of enlarged mediastinal lymph nodes on subsequent thoracic surgery rates. Gastrointest Endosc. 2004; 60 340-346
- 69 Annema J T, Versteegh M I, Veselic M et al.. Endoscopic ultrasound added to mediastinoscopy for preoperative staging of patients with lung cancer. JAMA. 2005; 294 931-936
- 70 Eloubeidi M A, Cerfolio R J, Chen V K, Desmond R, Syed S, Ojha B. Endoscopic ultrasound-guided fine needle aspiration of mediastinal lymph node in patients with suspected lung cancer after positron emission tomography and computed tomography scans. Ann Thorac Surg. 2005; 79 263-268
- 71 Annema J T, Versteegh M I, Veselic M, Voigt P, Rabe K F. Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of lung cancer and its impact on surgical staging. J Clin Oncol. 2005; 23 8357-8361
- 72 Tournoy K G, Praet M M, Van Maele G, van Meerbeeck J P. Esophageal endoscopic ultrasound with fine-needle aspiration with an on-site cytopathologist: high accuracy for the diagnosis of mediastinal lymphadenopathy. Chest. 2005; 128 3004-3009
- 73 Wallace M B, Ravenel J, Block M I et al.. Endoscopic ultrasound in lung cancer patients with a normal mediastinum on computed tomography. Ann Thorac Surg. 2004; 77 1763-1768
- 74 LeBlanc J K, Devereaux B M, Imperiale T F et al.. Endoscopic ultrasound in non-small cell lung cancer and negative mediastinum on computed tomography. Am J Respir Crit Care Med. 2005; 171 171-182
- 75 Fernandez-Esparrach G, Gines A, Belda J et al.. Transesophageal ultrasound-guided fine needle aspiration improves mediastinal staging in patients with non-small cell lung cancer and normal mediastinum on computed tomography. Lung Cancer. 2006; 54 35-40
- 76 Bhutani M S, Hawes R H, Hoffman B J. A comparison of the accuracy of echo features during endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration for diagnosis of malignant lymph node invasion. Gastrointest Endosc. 1997; 45 474-479
- 77 Annema J T, Veselic M, Versteegh M I, Willems L N, Rabe K F. Mediastinal restaging: EUS-FNA offers a new perspective. Lung Cancer. 2003; 42 311-318
- 78 Varadarajulu S, Eloubeidi M. Can endoscopic ultrasonography-guided fine-needle aspiration predict response to chemoradiation in non-small cell lung cancer? A pilot study. Respiration. 2006; 73 213-220
- 79 Larsen S S, Vilmann P, Krasnik M et al.. Endoscopic ultrasound guided biopsy performed routinely in lung cancer staging spares futile thoracotomies: preliminary results from a randomised clinical trial. Lung Cancer. 2005; 49 377-385
- 80 Wallace M B, Pascual J, Raimondo M et al.. Endoscopic ultrasound, endobronchial ultrasound and bronchoscopic fine needle aspiration for the staging of suspected lung cancer. Chest. 2007; 132 S470-S471
- 81 Ribeiro A, Vazquez-Sequeiros E, Wiersema L M et al.. EUS-guided fine-needle aspiration combined with flow cytometry and immunocytochemistry in the diagnosis of lymphoma. Gastrointest Endosc. 2001; 53 485-491
- 82 Storch I, Jorda M, Thurer R et al.. Advantage of EUS Trucut biopsy combined with fine-needle aspiration without immediate on-site cytopathologic examination. Gastrointest Endosc. 2006; 64 505-511
- 83 Annema J T, Veselic M, Rabe K F. Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of sarcoidosis. Eur Respir J. 2005; 25 405-409
- 84 Fritscher-Ravens A, Sriram P V, Topalidis T et al.. Diagnosing sarcoidosis using endosonography-guided fine-needle aspiration. Chest. 2000; 118 928-935
- 85 Wildi S M, Judson M A, Fraig M et al.. Is endosonography guided fine needle aspiration (EUS-FNA) for sarcoidosis as good as we think?. Thorax. 2004; 59 794-799
- 86 Kramer H, Koeter G H, Sleijfer D T, van Putten J W, Groen H J. Endoscopic ultrasound-guided fine-needle aspiration in patients with mediastinal abnormalities and previous extrathoracic malignancy. Eur J Cancer. 2004; 40 559-562
- 87 Wildi S M, Hoda R S, Fickling W et al.. Diagnosis of benign cysts of the mediastinum: the role and risks of EUS and FNA. Gastrointest Endosc. 2003; 58 362-368
- 88 Annema J T, Veselic M, Versteegh M I, Rabe K F. Mediastinitis caused by EUS-FNA of a bronchogenic cyst. Endoscopy. 2003; 35 791-793
- 89 Chang K J, Albers C G, Nguyen P. Endoscopic ultrasound-guided fine needle aspiration of pleural and ascitic fluid. Am J Gastroenterol. 1995; 90 148-150
- 90 Shami V M, Jones D R, Hernandez A, Stelow E B. Endoscopic ultrasound-guided fine needle aspiration of a malignant pleural effusion to diagnose and stage lung cancer: when should this approach be considered?. Dig Dis Sci. 2008; 53 757-759
- 91 Jhala N C, Jhala D, Eloubeidi M A et al.. Endoscopic ultrasound-guided fine-needle aspiration biopsy of the adrenal glands. Cancer. 2004; 102 308-314
- 92 Koh D M, Burke S, Davies N, Padley S P. Transthoracic US of the chest: clinical uses and applications. Radiographics. 2002; 22 E1
- 93 Beckh S, Bolcskei P L, Lessnau K D. Real-time chest ultrasonography: a comprehensive review for the pulmonologist. Chest. 2002; 122 1759-1773
- 94 Tsai T H, Yang P C. Ultrasound in the diagnosis and management of pleural disease. Curr Opin Pulm Med. 2003; 9 282-290
- 95 Herth F J, Becker H D. Transthoracic ultrasound. Respiration. 2003; 70 87-94
- 96 Evans A L, Gleeson F V. Radiology in pleural disease: state of the art. Respirology. 2004; 9 300-312
- 97 Diacon A H, Theron J, Bolliger C T. Transthoracic ultrasound for the pulmonologist. Curr Opin Pulm Med. 2005; 11 307-312
- 98 Feller-Kopman D. Therapeutic thoracentesis: the role of ultrasound and pleural manometry. Curr Opin Pulm Med. 2007; 13 312-318
- 99 Grogan D R, Irwin R S, Channick R et al.. Complications associated with thoracentesis: a prospective, randomized study comparing three different methods. Arch Intern Med. 1990; 150 873-877
- 100 Eibenberger K L, Dock W I, Ammann M E et al.. Quantification of pleural effusions: sonography versus radiography. Radiology. 1994; 191 681-684
- 101 Vignon P, Chastagner C, Berkane V et al.. Quantitative assessment of pleural effusion in critically ill patients by means of ultrasonography. Crit Care Med. 2005; 33 1757-1763
- 102 Jones P W, Moyers J P, Rogers J T et al.. Ultrasound-guided thoracentesis: is it a safer method?. Chest. 2003; 123 418-423
- 103 Balik M, Plasil P, Waldauf P et al.. Ultrasound estimation of volume of pleural fluid in mechanically ventilated patients. Intensive Care Med. 2006; 32 318-321
- 104 Kohan J M, Poe R H, Israel R H et al.. Value of chest ultrasonography versus decubitus roentgenography for thoracentesis. Am Rev Respir Dis. 1986; 133 1124-1126
- 105 Weingardt J P, Guico R R, Nemcek Jr A A, Li Y P, Chiu S T. Ultrasound findings following failed, clinically directed thoracenteses. J Clin Ultrasound. 1994; 22 419-426
- 106 Diacon A H, Brutsche M H, Soler M. Accuracy of pleural puncture sites: a prospective comparison of clinical examination with ultrasound. Chest. 2003; 123 436-441
- 107 Tu C Y, Hsu W H, Hsia T C et al.. Pleural effusions in febrile medical ICU patients: chest ultrasound study. Chest. 2004; 126 1274-1280
- 108 Tremblay A, Michaud G. Single-center experience with 250 tunnelled pleural catheter insertions for malignant pleural effusion. Chest. 2006; 129 362-368
- 109 Tremblay A, Mason C, Michaud G. Use of tunnelled catheters for malignant pleural effusions in patients fit for pleurodesis. Eur Respir J. 2007; 30 759-762
- 110 Jimenez C A, Mhatre A D, Martinez C H, Eapen G A, Onn A, Morice R C. Use of an indwelling pleural catheter for the management of recurrent chylothorax in patients with cancer. Chest. 2007; 132 1584-1590
- 111 Diacon A H, Theron J, Schubert P et al.. Ultrasound-assisted transthoracic biopsy: fine-needle aspiration or cutting-needle biopsy?. Eur Respir J. 2007; 29 357-362
- 112 Targhetta R, Bourgeois J M, Chavagneux R et al.. Ultrasonic signs of pneumothorax: preliminary work. J Clin Ultrasound. 1993; 21 245-250
- 113 Sugama Y, Tamaki S, Kitamura S, Kira S. Ultrasonographic evaluation of pleural and chest wall invasion of lung cancer. Chest. 1988; 93 275-279
- 114 Suzuki N, Saitoh T, Kitamura S. Tumor invasion of the chest wall in lung cancer: diagnosis with US. Radiology. 1993; 187 39-42
Marcus P KennedyM.D.
Respiratory Medicine, Sligo General Hospital
The Mall, Co. Sligo, Republic of Ireland
Email: kennedymarcus@hotmail.com