Rapid on-site evaluation with BIOEVALUATOR(®) during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing pulmonary and mediastinal diseases

Rapid on-site evaluation (ROSE) is used widely during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). BIOEVALUATOR(®) is a device used for determining whether the tissues obtained by EBUS-TBNA are appropriate for a pathological diagnosis. This study describes our experience with ROSE using BIOEVALUATOR(®) during EBUS-TBNA for diagnosing pulmonary and mediastinal diseases.

We retrospectively evaluated the results of 35 patients who underwent EBUS-TBNA with BIOEVALUATOR(®) between December 2011 and February 2013. For the diagnosis, the tissue areas were appearing white and red through BIOEVALUATOR(®) are considered to be appropriate and inappropriate, respectively. We examined their medical records to obtain information concerning the examination of BIOEVALUATOR(®) results of the patient's materials (white/red), the diagnosis yield, site and size of lymph nodes and number of needle passes.

The median longest diameter of 40 lymph nodes (21 #7, 13 #4R, 4 #4L and 2 #11) from 35 patients was 27.9 (range 12.4-50.6) mm and the median number of needle passes was 2 (range 1-5). The definitive diagnosis was made by EBUS-TBNA in 28 of 35 patients, by thoracotomy in one patient and BIOEVALUATOR(®) results were white and lymphocytes were seen in the rest six patients. The BIOEVALUATOR(®) results of other patients without accurate diagnosis were left indefinitive. Finally, the six patients were judged as having benign lymphadenopathy because the lymph node size on computed tomography decreased or remained stable after for at least 8 months.

Checking aspirated samples using BIOEVALUATOR(®) appears useful for determining their adequacy for pathological diagnosis.