Better Scope for Lung Disease Diagnosis

Sarcoidosis is better visualized with ultrasound based endoscope as compared to bronchoscopy

(RxWiki News) Early diagnosis of sarcoidosis is key to preventing severe organ damage. This disease, which causes inflammation of body organs, can lead to permanent scarring of tissue if untreated.

Results of a new study showed that endosonography, a technique that uses ultrasound waves along with a flexible scope to examine lung tissue, can help doctors spot sarcoidosis lumps better than bronchoscopy can.

According to this study, small lung masses linked to sarcoidosis were identified accurately in a notably higher percentage of patients as compared to bronchoscopy.


Ask your physician about new tests for lung disease.


The study was conducted by Martin B. von Bartheld, MD, of Leiden University Medical Center in The Netherlands, and colleagues.

The aim of the study was to examine the difference between bronchoscopy and endosonography in diagnosing sarcoidosis, a disease that causes inflammation and small lump-like masses in the lungs and other body areas.

During bronchoscopy, doctors look at the lungs using a flexible scope attached to a light source to see if there are any masses associated with sarcoidosis. Tissue samples (biopsies) may be removed during this procedure for further evaluation. Endosonography uses a scope and ultrasound waves to diagnose sarcoidosis. Tissue may also be aspirated from chest lymph nodes during this procedure so it can be examined under a microscope.

The researchers conducted a trial on 304 patients with suspected early stage lung sarcoidosis across 14 centers in six countries between 2009 and 2011.

One randomly chosen group of patients (149 patients) underwent bronchoscopy along with a lung biopsy. The other group (155 patients) underwent endosonography along with aspiration of tissue from chest lymph nodes.

The researchers found they were able to detect significantly more lung masses called granulomas in patients who underwent endsonography (74 percent) than the patients who underwent bronchoscopy (48 percent).

Also, they found that sarcoidosis masses were identified correctly in 80 percent of the patients who underwent endosonography, as compared to 53 percent patients in the bronchoscopy. This percentage number was known as diagnostic yield.

The number of adverse events in the groups did not differ substantially and all patients recovered completely.

The results of the study suggest that endosonography combined with lymph node aspiration had a greater diagnostic yield than bronchoscopy combined with lung biopsy.

"How will the outcomes of this study affect future diagnostic strategies for patients with suspected sarcoidosis? For patients who require tissue sampling either to confirm sarcoidosis before treatment or to exclude similar presenting diseases such as tuberculosis and lymphoma, the outcomes of this study indicate that endosonographic evaluation is likely to have the highest diagnostic yield," wrote the researchers.

The study results were published June 19 in the Journal of the American Medical Association.

The study was funded by the Department of Pulmonology, Leiden University Medical Center, Leiden, the Netherlands and the study sites themselves. No disclosures were available.

Review Date: 
June 19, 2013