{"entity":{"id":"ebus-tbna","kind":"term","name":"Endobronchial ultrasound (EBUS-TBNA)","aka":["EBUS","endobronchial ultrasound","EBUS-TBNA","endobronchial ultrasound-guided transbronchial needle aspiration","EUS-FNA","endoscopic ultrasound-guided fine-needle aspiration","endosonography"],"tldr":"A camera with an ultrasound probe on its tip is passed down the windpipe; the ultrasound finds the lymph nodes sitting just outside the airway wall and a needle is passed through the wall to sample them. It is how lung cancer is staged without an operation.","summary":"Getting the nodal stage right decides whether a lung cancer is operable, and imaging cannot do it alone: CT only shows that a node is enlarged and PET only that it is metabolically active, and both are wrong often enough to matter. Endobronchial ultrasound-guided transbronchial needle aspiration samples the paratracheal, hilar and subcarinal stations through the airway wall; endoscopic ultrasound-guided fine-needle aspiration reaches the inferior mediastinal and left-sided stations through the oesophagus; together they cover most of the mediastinum. NICE NG122 asks for EBUS-TBNA for paratracheal and peri-bronchial lesions, and for EBUS-TBNA or EUS-FNA or both wherever the nodal stage would change treatment, with surgical mediastinal staging held back for a negative result with continuing high suspicion. It also asks every cancer alliance to have at least one centre offering them and to audit local test performance, and it dropped transthoracic needle biopsy, plain bronchoscopy and non-ultrasound-guided needle aspiration from nodal staging because they do not reach the required sensitivity. The ninth edition of TNM raised the stakes: N2 is now split into N2a and N2b by how many mediastinal stations are involved, so a systematic sampling of each suspicious station, rather than a single positive node, is what the stage now needs.","asOf":"2026-09-25","wikipedia":"https://en.wikipedia.org/wiki/Endobronchial_ultrasound","links":[{"label":"NICE NG122: lung cancer, diagnosis and staging (published 28 March 2019, last updated 8 March 2024)","url":"https://www.nice.org.uk/guidance/ng122/chapter/Diagnosis-and-staging"},{"label":"Rami-Porta, J Thorac Oncol 2024: IASLC lung cancer staging project, proposals for revision of the TNM stage groups in the forthcoming ninth edition (76,518 patients analysed of 124,581 registered)","url":"https://doi.org/10.1016/j.jtho.2024.02.011"},{"label":"Br J Radiol 2025: something old something new, introduction to the ninth edition TNM classification of lung cancer (effective 1 January 2025)","url":"https://doi.org/10.1093/bjr/tqaf161"}],"tags":["lung"],"related":[],"cancers":["nsclc","sclc","lung-cancer","lung-lcnec"],"sections":[],"technologies":["bronchoscopy","ct","pet"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["mediastinal-lymph-node-stations","tnm-9-lung-cancer","resectability-lung-cancer","bronchoscopy","mediastinum"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Diagnostics & imaging"},"route":"/terms/ebus-tbna/","neighbours":{"cancer":[{"id":"lung-lcnec","kind":"cancer","name":"Large cell neuroendocrine carcinoma of the lung","route":"/cancers/lung-lcnec/"},{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"sclc","kind":"cancer","name":"Small-cell lung cancer","route":"/cancers/sclc/"}],"term":[{"id":"bronchoscopy","kind":"term","name":"Bronchoscopy (EBUS, robotic navigation)","route":"/terms/bronchoscopy/"},{"id":"mediastinal-lymph-node-stations","kind":"term","name":"Mediastinal lymph node stations","route":"/terms/mediastinal-lymph-node-stations/"},{"id":"mediastinum","kind":"term","name":"Mediastinum","route":"/terms/mediastinum/"},{"id":"resectability-lung-cancer","kind":"term","name":"Resectability in lung cancer","route":"/terms/resectability-lung-cancer/"},{"id":"tnm-9-lung-cancer","kind":"term","name":"TNM 9: what changed in lung cancer staging","route":"/terms/tnm-9-lung-cancer/"},{"id":"ttf1-p40","kind":"term","name":"TTF-1 and p40 (how lung histology is decided)","route":"/terms/ttf1-p40/"}],"technology":[{"id":"ct","kind":"technology","name":"CT (computed tomography)","route":"/technologies/ct/"},{"id":"pet","kind":"technology","name":"PET (positron emission tomography)","route":"/technologies/pet/"}]}}