ArticleCHEST pulmonary2026
Impact of Rapid Cytologic Evaluation of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration on the Value of Adjunctive Transbronchial Biopsy in Sarcoidosis.
Article in CHEST pulmonary, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: When bronchoscopy with endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) is performed to diagnose sarcoidosis, rapid on-site cytologic evaluation (ROSE) permits selective use of adjunctive transbronchial biopsy (aTBB), improving aTBB safety. Current sarcoidosis guidelines discourage use of aTBB but do not address whether ROSE impacts these recommendations. Research Question: Does ROSE improve the diagnostic sensitivity of aTBB for an incremental diagnosis of sarcoidosis (ISaTBB) enough to justify routinely performing aTBB? Study Design and Methods: We retrospectively studied patients undergoing EBUS-TBNA who were diagnosed with sarcoidosis and used observed data and modeling to determine ISaTBB with and without ROSE. Results: Sarcoidosis was diagnosed in 156 individuals who underwent bronchoscopy with 4.5 years of median follow-up. Diagnostic sensitivities for EBUS-TBNA final cytology, ROSE, and transbronchial biopsy were 0.85, 0.66, and 0.54 (entire cohort); 0.94, 0.75, and 0.55 (stage 1 chest radiograph [CXR] group); and 0.69, 0.50, and 0.71 (stage 2 CXR group). Using these sensitivities, modeling showed ROSE improved ISaTBB from 0.08 to 0.23 (entire cohort), 0.03 to 0.12 (stage 1 CXRs), and 0.22 to 0.40 (stage 2 CXRs). These ISaTBBs indicate ROSE decreased the number of individuals expected to undergo aTBB for each incremental diagnosis from 33 to 8 (stage 1 CXRs) and from 5 to 3 (stage 2 CXRs), corresponding to pneumothorax risks per incremental diagnosis that decreased from 67% to 15% (stage 1 CXRs) and 9% to 5% (stage 2 CXRs). Modeling predicted aTBB increased bronchoscopy's sensitivity for sarcoidosis from 94% to 97% (stage 1 CXRs) and from 69% to 91% (stage 2 CXRs). Interpretation: Our results suggest that aTBB should not be used to diagnose sarcoidosis in individuals with stage 1 CXRs even when ROSE is used. The risk averse may choose to avoid aTBB in those with stage 2 CXRs, but ROSE should be used to improve safety if aTBB is planned in this group.
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