Endobronchial Ultrasound (EBUS), also known as Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA), is a procedure used to assess areas inside the lungs and nearby lymph nodes. It helps determine:
– If an abnormal area is cancerous
– The size of a tumour or abnormal growth
– Whether the cancer has spread within or beyond the lungs
How Does EBUS Work
A narrow, flexible tube with an ultrasound probe is inserted into the airways. The ultrasound probe emits high-frequency sound waves, creating detailed images of lung tissue and structures surrounding the airways, such as lymph nodes. Your doctor can take tissue samples (biopsies) from any abnormal areas for further testing.
The procedure usually takes place in the endoscopy unit at a hospital and lasts around 40 to 60 minutes.
Why Might You Need an EBUS
EBUS is generally recommended after an abnormal area is identified on an x-ray or CT scan, or if there are enlarged lymph nodes.
- Diagnosing and staging lung cancer and mesothelioma
- Tuberculosis
- Respiratory infections / infection
- Sarcoidosis, silicosis or other inflammatory lung conditions
- Pulmonary nodules
- Lymphoma
- Conditions that cause enlargement of the mediastinal lymph nodes and the higher lymph nodes
Preparation for an EBUS-TBNA
Fasting: You’ll be instructed not to eat or drink for a few hours before the test.
Medication Adjustments: Continue taking regular medications unless directed otherwise. If you take blood thinners, you’ll need to stop these before the test as instructed by your doctor.
On the Day of the Test
Before the Procedure:
Vitals Check: Your blood pressure, heart and breathing rates, oxygen levels, and weight will be measured.
Consent: The doctor will explain the procedure and ask you to sign a consent form.
Changing Clothes: You may need to wear a hospital gown.
During the Procedure:
Local Anaesthetic with sedation: If using local anaesthetic, you will be given a sedative to help you relax. A local anaesthetic will numb your nose and throat to minimise discomfort.
General Anaesthetic: If undergoing general anaesthesia, a cannula is placed in your arm to administer the anaesthetic.
The doctor then inserts the bronchoscope through your mouth or nose to examine the airways and collect any necessary tissue samples. Oxygen levels and heart rate will be monitored throughout.
After the Test:
Recovery: You’ll remain in a recovery area until the effects of the anaesthetic wear off. Avoid eating or drinking until the anaesthetic in your throat wears off, usually after about an hour.
Going Home: Most patients go home the same day. If you received a sedative or anaesthetic, arrange for someone to accompany you, as you should avoid driving, alcohol, and heavy machinery for 24 hours.
Potential Risks of EBUS
While EBUS is generally safe, some rare risks include:
Bleeding: Small amounts of blood in your spit are common. Notify your doctor if it persists.
Chest Infection: Contact your GP if your phlegm changes colour, you become more breathless, or you develop a fever.
Pneumothorax (Collapsed Lung): In rare cases, air can build up around the lung, causing it to collapse. Seek medical attention if you experience sudden chest pain or difficulty breathing.
Mediastinitis: This rare infection or inflammation of the chest area may require hospital treatment with intravenous antibiotics.
Your healthcare provider will discuss these risks and provide contacts for any follow-up questions or concerns after the procedure.
Dr Diwanji has extensive experience with EBUS, having performed over 1,500 procedures, making him highly skilled in this diagnostic technique.