Comparing Two Needle Agitation Methods During Endobronchial Ultrasound-Guided Needle Biopsy for Enlarged Chest Lymph Nodes

What this Trial Is About

Researchers are evaluating whether the number of needle agitations during endobronchial ultrasound-guided transbronchial needle aspiration EBUS-TBNA affects diagnostic accuracy in patients with enlarged mediastinal lymph nodes. This study aims to compare two needle agitation strategies to see if one improves diagnostic yield, tissue sample quality, and safety. The trial addresses the lack of high-level evidence about the best agitation technique and seeks to standardize procedural methods to optimize outcomes while maintaining safety. Participants will be randomly assigned to one of two needle agitation strategies during EBUS-TBNA a low-range strategy with 10 to fewer than 30 agitations per needle pass target about 20 or a high-range strategy with 30 to 60 agitations per pass target about 45 to 50. All other procedural factors, such as needle type, number of passes, suction technique, and specimen handling, will be kept consistent between groups to isolate the effect of agitation number. Participants will undergo EBUS-TBNA as part of their clinical evaluation and have tissue samples measured for core length and assessed for diagnostic adequacy immediately after the procedure. Researchers will monitor for procedure-related complications to assess safety. The main outcome is diagnostic yield within 7 to 14 days after the procedure. The study starts in February 2026 and continues through December 2028, with participants closely followed during and shortly after the procedure.

Comparison of Two Needle Agitation Strategies in Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) for Diagnostic Yield