Interventional pulmonology: The role of rndobronchial ultrasound in mediastinal staging of lung cancer

Lung cancer remains the leading cause of cancer deaths in the United States. The initial work up and diagnostic testing for lung cancer is focused on appropriate staging of the disease. Prognostic data including response to treatment and survival as well as guidance for treatment management have all been closely linked with lung cancer staging.This relationship between group staging and response to treatment and survival has made proper diagnostic testing and sampling crucial in the diagnosis and treatment of lung cancer. Clinical or noninvasive staging can differ markedly from true pathologic staging.Bronchoscopy is a procedure utilizing a small flexible scope which is inserted via the oropharyngeal route into the airways, allowing direct visualization of the central and distal airways as well as access to the mediastinum. The recent introduction of endobronchial ultrasound-guided bronchoscopy has further improved the safety and yield of these procedures. This procedure provides a minimally invasive approach for the diagnosis of metastatic lung cancer as well as a high specificity.The current trends in lung cancer diagnosis and staging will likely position endobronchial ultrasound-guided bronchoscopy as the procedure of choice for the initial diagnosis and staging of lung cancer.