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Endoscopic ultrasound with fine-needle aspiration improves staging for certain lung cancers

Mediastinal Endoscopic Ultrasound

UCLA offers endoscopic ultrasound with fine-needle aspiration (EUS-FNA) as a minimally invasive approach to obtain mediastinal lymph node tissue samples that aid in the diagnosis and/or staging of patients with:

• established or suspected non-small cell lung cancer
• posterior and/or inferior mediastinal lymph nodes seen on cross sectional imaging (CT, MRI, or PETscans) for confirmatory tissue diagnosis
• sarcoidosis
• suspected lymphomas in the mediastinum

Additionally, EUS allows non-invasive tissue sampling from the left adrenal gland and significant portions of the liver, which are important organs to which lung cancer can spread.

Integrating two technologies

EUS enables physicians to access organs that conventional endoscopy cannot by wending an endoscope tipped with an ultrasound probe to the point of interest. EUS is a combination of two state-of-the-art technologies:

• Endoscopy – a flexible lighted tube that facilitates examination of internal organs
• Ultrasound – high-frequency sound waves, transmitted by ultrasound probes, that create cross-sectional images of internal organs

Benefits of procedure outweigh risks

The level of risk associated with EUS-FNA is low and comparable to other commonly performed endoscopic examinations. EUS-FNA for staging lung cancer carries an extremely low complication rate; the procedure is generally performed on an outpatient basis while the patient is in a state of conscious sedation.

EUS-FNA is arguably the most sensitive method of diagnosis for posterior mediastinal lymph nodes and other suspicious lesions. (In experienced hands, the study’s sensitivity for these lesions is as high as 90 to 95 percent.)

EUS was recognized initially for its accuracy in the diagnosis and staging of digestive diseases, and has established its value in experienced hands as a routine procedure for lung cancer patients.

Program leaders

Navid Madani, M.D.
Assistant Professor of Medicine
Mediastinal EUS Program
James J. Farrell, M.D.
Assistant Professor of Medicine
Director, UCLA Endoscopic Ultrasound

Contact information

For appointments for both consultation and endoscopic evaluation procedures at UCLA, please call:
310-206-3727 (310-206-ERCP) or 310-267-3636 (310-267-ENDO)

Department of Medicine/Division of Digestive Diseases

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