While navigational bronchoscopy (NB) and convex-probe endobronchial ultrasound transbronchial needle aspiration (CP-EBUS-TBNA) are commonly performed in a single setting to evaluate suspicious pulmonary lesions, evidence suggests wide variation in which is performed first, with benefits for choosing each first. For a study, researchers identified procedures that included both NB and CP-EBUS-TBNA sampling, all of which had an NB first strategy. To determine incidence of NB first strategy failure, they assessed the percentage of malignant diagnoses that could have been secured by performing CP-EBUS-TBNA first, therefore making the NB component obsolete. Among 50 lesion assessments, a malignant diagnosis was obtained via NB-acquired samples in 30, among which seven (23%) were able to be obtained via CP-EBUS-TBNA and the NB component could have been avoided, potentially saving time and associated costs. “Our findings suggest that a CP-EBUS-TBNA first approach may be able to avoid NB in select cases,” write the study authors. “An NB first strategy can be advantageous in certain clinical scenarios. It is likely best to make these decisions on a case-by-case basis and tailor the strategy to the patient’s individual needs.”
