This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Related letters  • Similar articles in JAMA  Topic Collections  • Oncology  • Lung Cancer  • Pulmonary Diseases  • Surgery  • Surgical Interventions  • Endoscopy/ Minimally Invasive Surgery  • Diagnosis  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Dr Navani and colleagues raise the issue of the optimal number of passes of the TBNA needle into each lymph node. In one study, up to 7 TBNA passes were needed to maximize the sensitivity, although in that study more than 80% of positive diagnoses were obtained by the third FNA pass.¹ Another study of the relationship between number of passes and sensitivity using EUS-FNA found that 3 passes were needed to maximize the sensitivity.² Given the need to make a fair head-to-head comparison, we chose a uniform number of passes (at least 3) for all 3 procedures. We accept that more passes by TBNA may have increased the yield, and it is appropriate in settings where EUS-FNA or EBUS-FNA are not available. Similarly, the use of ROSE is most helpful when ultrasound guidance is not available but does increase the cost and time needed for the procedure. . . . [Full Text of this Article]

Michael B. Wallace, MD, MPH
wallace.michael@mayo.edu
Department of Medicine
Mayo Clinic
Jacksonville, Florida

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Minimally Invasive Endoscopic Staging of Suspected Lung Cancer
Michael B. Wallace, Jorge M. S. Pascual, Massimo Raimondo, Timothy A. Woodward, Barbara L. McComb, Julia E. Crook, Margaret M. Johnson, Mohammad A. Al-Haddad, Seth A. Gross, Surakit Pungpapong, Joy N. Hardee, and John A. Odell
JAMA. 2008;299(5):540-546.
ABSTRACT | FULL TEXT  

RELATED LETTERS

Lung Cancer Staging With Minimally Invasive Endoscopic Techniques
Neal Navani, Sam M. Janes, and Stephen G. Spiro
JAMA. 2008;299(21):2509.
EXTRACT | FULL TEXT  

Lung Cancer Staging With Minimally Invasive Endoscopic Techniques
Domenico Galetta, Maria Serra, and Lorenzo Spaggiari
JAMA. 2008;299(21):2509-2510.
EXTRACT | FULL TEXT  

Lung Cancer Staging With Minimally Invasive Endoscopic Techniques
Jouke T. Annema, Kurt G. Tournoy, and Klaus F. Rabe
JAMA. 2008;299(21):2510.
EXTRACT | FULL TEXT