Is Routine Chest Radiography Necessary After Endobronchial Ultrasound-guided Fine Needle Aspiration?

Area of Science:

• Pulmonology
• Radiology
• Medical Economics

Background:

• Chest radiography is standard after endobronchial ultrasound-guided fine needle aspiration (EBUS-FNA) to detect pneumothorax.
• The established rate of postprocedure pneumothorax is low, questioning the necessity of routine imaging.

Purpose of the Study:

• To determine if routine chest radiography can be safely omitted after EBUS-FNA.
• To assess the potential cost savings associated with eliminating routine post-procedure chest radiography.

Main Methods:

• Retrospective analysis of 757 patients undergoing EBUS-FNA between January 2017 and December 2018.
• Comparison of outcomes between patients who did and did not receive routine postprocedure chest radiography.
• Univariate regression analysis to identify predictive factors for pneumothorax.

Main Results:

• Only 1.5% of patients developed pneumothorax; 0.1% had symptomatic pneumothorax.
• No clinically evident pneumothorax occurred in the 209 patients who did not undergo routine chest radiography.
• Eliminating routine radiography could save an estimated $33,950.

Conclusions:

• The extremely low incidence of pneumothorax makes routine chest radiography after EBUS-FNA statistically uninformative.
• Omission of routine chest radiography post-EBUS-FNA is likely safe and offers significant cost benefits.