Endobronchial ultrasound guided transbronchial needle aspiration of mediastinal lymph nodes for lung cancer staging: a projected cost analysis

Endobronchial ultrasound guided-transbronchial needle aspiration (EBUS-TBNA) of mediastinal lymph nodes provides a safe alternative to mediastinoscopy for staging patients with lung cancer. Performing TBNA under real time ultrasound visualisation has been shown to significantly improve the yield of TBNA compared with conventional TBNAperformed without visualisation. In addition to the clinical benefits of this procedure, EBUSTBNA is likely to offer ongoing cost savings by avoiding the need for mediastinoscopy procedures and positron emission topography (PET) scans in some patients. At Leeds Teaching Hospitals NHS Trust (LTHT), conventional TBNA is used to assess large subcarinal nodes, but the Trust does not currently offer an EBUS-TBNA service. By reviewing mediastinoscopies performed as staging procedures for lung cancer in LTHT during 2006, we estimated the financial implications of establishing an EBUS-TBNA service.