The diagnosis of lung cancer has evolved significantly thanks to techniques such as EBUS and Cryo-EBUS, which facilitate the collection of accurate samples in a minimally invasive way. A precise diagnosis from the outset is essential in order to decide on the most appropriate and personalised treatment for each patient.
In the assessment of lung diseases, especially in the case of suspected cancer, the quality of the sample obtained makes the difference between a generic treatment and a true precision medicine.
EBUS (Endobronchial Ultrasound), also known as Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA), is a procedure that combines the visualisation of a bronchoscopy with the precision of ultrasound imaging.
Using a flexible device, the specialist can visualise in real time the structures around the bronchi, including mediastinal lymph nodes.
EBUS allows physicians to accurately diagnose lung masses or tumours and to stage the cancer by checking whether there are metastatic lymph nodes in order to plan the most appropriate treatment.
Studies show that EBUS is a crucial tool for the diagnosis of thoracic disorders, especially lung cancer, with a diagnostic yield that may exceed 50% in complex cases. It is safe, low risk, and performed under sedation for patient comfort.
The Cryo-EBUS Marbella technique represents an evolution compared to conventional EBUS.
While conventional EBUS retrieves cells for analysis, Cryo-EBUS allows the extraction of small, complete and better-preserved tissue fragments.
This is important because:
- Increases diagnostic accuracy. The reliability of the diagnosis obtained by Cryo-EBUS is equal to that of a traditional surgical biopsy, with the advantage of being an outpatient procedure and much less invasive.
- Allows for more complete tissue studies. By obtaining a complete tissue fragment and not just isolated cells, the sample preserves all the architecture required for analysis.
- Precision medicine: Having sufficient tissue is vital for molecular and genetic studies. This allows the use of targeted therapies that are much more effective against the specific profile of each tumour.
The key differentiating factor in our service lies in the Cryo-EBUS technique. While conventional EBUS usually extracts single cell samples (cytology), Cryo-EBUS uses a freezing probe to obtain a histological biopsy.
- Higher quality samples: By obtaining a complete tissue fragment and not just isolated cells, the sample preserves all the architecture required for analysis.
- Comparable to surgery: The reliability of the diagnosis obtained by Cryo-EBUS approaches that of a traditional surgical biopsy, with the advantage of being an outpatient procedure and much less invasive.
The key advantages of Cryo-EBUS include:
- Higher diagnostic yield: it can achieve up to 95% accuracy, compared to 54% for traditional EBUS in certain thoracic diseases. It is superior in the diagnosis of benign and lymphoproliferative diseases.
- Better samples for advanced analysis: Samples are larger and with higher cellularity, facilitating genetic (such as NGS) and immunohistochemical tests essential for personalised lung cancer treatments.
- Minimally invasive and safe: Avoids major surgeries, with similar risks to standard EBUS, such as minor bleeding or pneumothorax in less than 1-7% of cases. Studies indicate that it is especially effective in obtaining preserved tissue without artefacts.
In summary, Cryo-EBUS not only expedites diagnosis, but also makes it more reliable, reducing the need for additional procedures and improving treatment options.
The procedure is performed on an outpatient basis and takes approximately 30-60 minutes. Under sedation, the physician inserts the ultrasound-guided bronchoscope into the lymph nodes or tumour. To carry out Cryo-EBUS, cold is applied to freeze and extract a sample of intact tissue for analysis in the laboratory. Recovery is quick, and most patients are able to return home the same day.
At HC Marbella, our team of specialists in oncology and respiratory medicine are highly qualified in the use of these state-of-the-art technologies. By incorporating EBUS and Cryo-EBUS, we are able to offer faster and more accurate diagnoses, improving survival rates and overall quality of life for our patients.
For more information, please contact our centre in Marbella.
Dr Ricardo Aguilar
Neumology Specialist
February 17, 2026
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