Up-to date role of interventional pulmonology in the diagnosis and staging of non-small-cell lung cancer

Lung cancer treatment plans depend entirely on accurate diagnosis and staging. Recent advances in bronchoscopic technology have provided the interventional pulmonologist with elegant and effective sampling methods that have improved the chances to get both tissue diagnosis and thorough mediastinal staging. Among these techniques, particular attentions deserve navigational bronchoscopy and radial endobronchial ultrasound (r-EBUS) for the diagnosis of peripheral lung nodules, as well as endosonography (EBUS-TBNA, EUS/EUS-b-NA) for both the mediastinal lymph node staging and the approach to peribronchial/esophageal central lesions. The main role of the Interventional Pulmonologist in this setting is to apply these procedures based on a correct interpretation of clinical and radiographic findings, in order to maximize the chances to achieving the diagnostic and staging information needed by the multidisciplinary lung cancer team for the optimal management of each specific case.