***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: STUDY OBJECTIVE To assess the ability of endobronchial ultrasonography ( EBUS ) using a guide sheath ( EBUS-GS ) to diagnose peripheral pulmonary lesions . METHOD We devised a technique for EBUS-GS covering a miniature probe , and 150 lesions were evaluated in a prospect i ve open study . In this procedure , the probe covered by a guide sheath is introduced into the lesion via the working channel of a bronchoscope . The probe is withdrawn , while the guide sheath is left in situ . A brush or biopsy forceps is introduced through the guide sheath into the lesion . RESULTS One hundred sixteen of 150 EBUS-GS procedures ( 77 % ) were diagnostic . Cases in which the probe was located within the lesion had a significantly higher diagnostic yield ( 105 of 121 cases , 87 % ) than when the probe was located adjacent to it ( 8 of 19 cases , 42 % ) [ p < 0.0001 , chi(2 ) ] . The diagnostic yield from EBUS-GS in lesions < /= 10 mm ( 16 of 21 lesions , 76 % ) , > 10 to < /= 15 mm ( 19 of 25 lesions , 76 % ; p = 0.99 , chi(2 ) ) , > 15 to < /= 20 mm ( 23 of 35 lesions , 66 % ; p = 0.41 , chi(2 ) ) , and > 20 to < /= 30 mm ( 33 of 43 lesions , 77 % ; p = 0.96 , chi(2 ) ) were similar , demonstrating the efficacy of EBUS-GS even in lesions < /= 10 mm in diameter . In 54 of 81 lesions < /= 20 mm , fluoroscopy was not able to confirm whether the forceps reached the lesion . However , the yield was the same with ( 67 % , 18 of 27 lesions ) and without ( 74 % , 40 of 54 lesions ) successful fluoroscopy ( p = 0.96 , chi(2 ) ) . Moderate bleeding occurred in two patients ( 1 % ) ; there were no other complications . CONCLUSIONS EBUS-GS is a useful method for collecting sample s from peripheral pulmonary lesions , even those too small to be visualized under fluoroscopy BACKGROUND Peripheral pulmonary lesions are technically challenging with conventional bronchoscopy in obtaining tissue diagnosis . The recently developed small-caliber ultrasonographic probe can be introduced via the working channel of a flexible bronchoscope to localize peripheral pulmonary lesions ( PPLs ) prior to transbronchial lung biopsy ( TBLB ) . The endobronchial ultrasound-guided transbronchial lung biopsy ( EBUS-TBLB ) is a new diagnostic method for the diagnosis of pulmonary lesions in our center . OBJECTIVE To evaluate the diagnostic yield of EBUS-TBLB in pulmonary lesions . STUDY DESIGN A prospect i ve cross-sectional study . MATERIAL AND METHOD We enrolled 152 patients with pulmonary lesions that were beyond the segmental bronchus and had no evidence of endobronchial lesion , who underwent bronchoscopy in our center . With EBUS assisted , transbronchial lung biopsy was performed after localizing and measuring distance from the tip of bronchoscope to the lesion . The diagnostic yield was calculated . RESULTS The pulmonary lesions were visible on EBUS image in 98.7 % of cases . The overall diagnostic yield of EBUS-TBLB was 66.4 % . The diagnostic yield in the infiltrative and mass lesions were 86.4 % and 63.1 % , respectively . The lesions which EBUS probe located within it were diagnosed by EBUS-TBLB about 74.8 % . The benign and malignant lesions were diagnosed by EBUS-TBLB about 81.1 % and 58.6 % , respectively . The average EBUS time was 3.55 + /- 2.29 minutes . No complication of EBUS and transbronchial lung biopsy were observed in this study . CONCLUSION EBUS-TBLB is a safe procedure for diagnosing pulmonary lesions . Our results indicate that the EBUS-TBLB improves the diagnostic yield compared to conventional brochoscopy PURPOSE To report results of a 5-year prospect i ve low-dose helical chest computed tomographic ( CT ) study of a cohort at high risk for lung cancer . MATERIAL S AND METHODS After informed written consent was obtained , 1520 individuals were enrolled . Protocol was approved by institutional review board and National Cancer Institute and was compliant with Health Insurance Portability and Accountability Act , or HIPAA . Participants were aged 50 years and older and had smoked for more than 20 pack-years . Participants underwent five annual ( one initial and four subsequent ) CT examinations . A significant downward shift was evaluated in non-small cell lung cancers detected initially from advanced stage down to stage I by using a one-sided binomial test of proportions . Poisson regression and Fisher exact tests were used for comparisons with Mayo Lung Project . RESULTS In 788 ( 52 % ) men and 732 ( 48 % ) women , 61 % ( 927 of 1520 ) were current smokers , and 39 % were former smokers . After five annual CT examinations , 3356 uncalcified lung nodules were identified in 1118 ( 74 % ) participants . Sixty-eight lung cancers were diagnosed ( 31 initial , 34 subsequent , three interval cancers ) in 66 participants . Twenty-eight subsequent cases of non-small cell cancers were detected , of which 17 ( 61 % ; 95 % confidence interval : 41 % , 79 % ) were stage I tumors . Diameter of cancers detected subsequently was 5 - 50 mm ( mean , 14.4 mm ; median , 10.0 mm ) . Analysis for a more than 50 % shift in proportion of stage I non-small cell cancer detection did not show statistical significance . Forty-eight participants died of various causes since enrollment . Lung cancer mortality rate for incidence portion of trial was 1.6 per 1000 person-years . There was no significant difference in lung cancer mortality rates of cancers detected in subsequent examinations between this trial and Mayo Lung Project after separation of participants into subsets ( 2.8 vs 2.0 per 1000 person-years , P = .43 ) . CONCLUSION CT allows detection of early-stage lung cancers . Benign nodule detection rate is high . Results suggest no stage shift STUDY OBJECTIVES We evaluated the feasibility and efficacy of transbronchial biopsy ( TBB ) and bronchial brushing by endobronchial ultrasonography ( EBUS ) with a guide sheath ( GS ) as a guide for diagnosing peripheral pulmonary lesions ( PPLs ) without radiographic fluoroscopy . PATIENTS One hundred twenty-one patients with 123 PPLs ( mean diameter , 31.0 mm ) whose bronchoscopic findings were normal . METHODS An EBUS-GS was inserted and advanced to the PPL without fluoroscopy . Once we obtained the EBUS image , the probe was withdrawn and the GS was left in place . TBB and /or bronchial brushing were performed via the GS . When an EBUS image could not be obtained , we changed to the bronchoscopic examination under fluoroscopy . RESULTS Seventy-six of 123 PPLs ( 61.8 % ) were diagnosed by EBUS-GS guidance without fluoroscopy . The diagnostic yield for PPLs > 20 mm in diameter ( 75.6 % ) was significantly higher than that for those < or= 20 mm in diameter ( 29.7 % ; p < 0.01 ) . The PPLs located in the middle lobe and the lingular segment had significantly higher diagnostic yields ( p < 0.05 ) . When the bronchus leading to the PPL was identified on the CT scan , the yield was 79.2 % . Moreover , the solid lesions had a higher diagnostic yield ( 67.0 % ) compared with nonsolid lesions ( 35.0 % ; p < 0.05 ) . Multivariate analysis revealed that the diameter and the location of the PPL were independent predictors of diagnostic sensitivity by EBUS-GS-guided bronchoscopy ( p < 0.05 ) . CONCLUSIONS EBUS-GS-guided bronchoscopy without the use of radiographic fluoroscopy is effective for diagnosing PPLs . The diameter , location , and CT scan appearance of the PPLs , and the identification of the bronchus leading to the PPLs were valuable as factors related to a higher diagnostic sensitivity with this procedure Transbronchial biopsy ( TBBX ) for peripheral lung lesions is usually performed with the help of fluoroscopy , but the yield varies widely . This feasibility study aim ed to assess the ability of endobronchial ultrasound ( EBUS ) to provide imaging guidance for TBBX . In a prospect i ve study , 50 consecutive patients referred for TBBX for peripheral lesions underwent fluoroscopy-guided and EBUS-guided TBBX in r and om order . Diagnostic yields were compared for both modalities and feasibility was assessed for EBUS . Diagnostic material was obtained in 80 % of patients with EBUS and 76 % of patients with fluoroscopy . There was a nonsignificant trend for EBUS to be better than fluoroscopy for lesions <3 cm in diameter . Four lesions could not be visualised with EBUS . There were no significant complications associated with the use of EBUS . Endobronchial ultrasound-guided transbronchial biopsy is feasible . It appears to be at least equivalent to fluoroscopy without the accompanying radiation exposure . Further large-scale studies are indicated to assess the possible role of endobronchial ultrasound as a potential imaging method of choice for the biopsy of peripheral lung lesions Background : Electromagnetic navigation has been approved for use as an adjunct to st and ard bronchoscopy . The diagnostic yield varies depending on the size of the lesion and successful navigation to the lesion . Objectives : The performance of two different biopsy tools , i.e. catheter aspiration and forceps biopsy , in the diagnosis of small pulmonary nodules ( SPN ) guided by electromagnetic navigational bronchoscopy ( ENB ) was examined . Methods : 54 patients referred for suspected lung cancer underwent ENB and 55 SPN ( <3 cm ) were sample d using both techniques .  Endobronchial ultrasound ( EBUS ) was used to verify the accuracy of target lesion localization by ENB . Primary end points of the study were successful navigation to the lesion and a positive diagnosis . Patients were followed until a definitive diagnosis was obtained . Results : All 55 lesions were accessed . Two lesions were excluded from data analysis as the patients were lost to follow-up and their diagnoses could not be confirmed . Of the remaining 53 lesions , 40 sample s ( 75.5 % ) were diagnostic . Compared to forceps biopsy , catheter aspiration was positively correlated with the success rate ( 36/40 vs. 22/40 ; p = 0.035 ) . The diagnostic yield was 93 % when EBUS verified the lesion location after navigation and only 48 % when lesion location was not confirmed . There were no significant complications . Conclusions : ENB is a useful tool in the evaluation of SPN <3 cm in diameter . For malignant lesions , sampling by catheter aspiration is associated with a higher diagnostic yield than sampling by forceps biopsy alone , in particular when EBUS could not confirm lesion location prior to sampling The present study prospect ively evaluated the diagnostic yield and safety of electromagnetic navigation-guided bronchoscopy biopsy , for small peripheral lung lesions in patients where st and ard techniques were nondiagnostic . The study was conducted in a tertiary medical centre on 40 consecutive patients considered unsuitable for straightforward surgery or computed tomography (CT)-guided transthoracic needle aspiration biopsy , due to comorbidities . The lung lesion diameter was mean±sem 23.5±1.5 mm and the depth from the visceral-costal pleura was 14.9±2 mm . Navigation was facilitated by an electromagnetic tracking system which could detect a position sensor incorporated into a flexible catheter advanced through a bronchoscope . Information obtained during bronchoscopy was superimposed on previously acquired CT data . Divergence between CT data and data obtained during bronchoscopy was calculated by the system 's software as a measure of navigational accuracy . All but one of the target lesions was reached and the overall diagnostic yield was 62.5 % ( 25–40 ) . Diagnostic yield was significantly affected by CT-to-body divergence ; yield was 77.2 % when estimated divergence was ≤4 mm . Three pneumothoraces occurred and chest drainage was required in one case . Electromagnetic navigation-guided bronchoscopy has the potential to improve the diagnostic yield of transbronchial biopsies without additional fluoroscopic guidance , and may be useful in the early diagnosis of lung cancer , particularly in nonoperable patients Background : The aim of this study was to evaluate the diagnostic utility of endobronchial ultrasound (EBUS)-guided transbronchial biopsy ( TBB ) using a novel 3.4-mm thin bronchoscope and a 1.4-mm ultrasonic probe for peripheral pulmonary lesions . Methods : A total of 86 patients with suspected peripheral lesions were included in this prospect i ve study . EBUS-TBBs were performed using a prototype 3.4-mm thin bronchoscope 
    Output:
    
Conclusion : Both technologies have a high proportion of successful PPL localization with similar sensitivity for malignancy and accuracy .