Perspective
Biopsy: bronchoscopy is best-interventional pulmonologists perspective
Abstract
Knowledge of pulmonary medicine along with extensive training in minimally invasive airway and lung procedures provides interventional pulmonologists with a unique perspective on the management of lung nodules. The evolution of lung cancer screening has resulted in an increase in the number of nodules identified in patients with high pre-test probability of cancer. The ability to sample nodules using electromagnetic navigation bronchoscopy (ENB) along with biopsying mediastinal lymph nodes using endobronchial ultrasound (EBUS) bronchoscopy during one procedure brands bronchoscopy as the modality of choice for diagnosing and staging individuals with malignant lung nodules. Neither computer tomography (CT) scanning nor positron emission tomography (PET) scanning is optimal modalities for staging the mediastinum. The ability of to safely and effectively biopsy nodules through ENB, along with simultaneous staging the mediastinum using EBUS, makes bronchoscopic biopsy the ideal approach for sampling lung nodules identified through lung cancer screening.