Background: Slim bronchoscopes (Olympus BF- P290) and radial Endobronchial Ultrasound (r-EBUS) are diagnostic modalities used for diagnosis of peripheral lung lesions. As a referral centre, we offer regional service for radial EBUS to hospitals in the North-west England. We performed an audit to evaluate the Radial-EBUS service in a university hospital in the UK. Our aim was to analyse the referral pathways, waiting period for the procedure and diagnostic yields in our centre.

Method: We performed retrospective audit of all radial EBUS referrals between June 2021 to May 2022 using electronic patient records. We analysed the data to assess the diagnostic yields and other service parameters for the radial EBUS service.

Results:39 patients were referred from local hospitals for radial-EBUS bronchoscopy during the study period. However only 22 out of 39 (56.41%) patients underwent radial-EBUS despite being referred for it. 10 out of 39 patients (25.64%) had endobronchial mass visible on bronchoscopy which included both slim and standard bronchoscopes. These patients did not need radial-EBUS bronchoscope. The diagnostic yield for radial-EBUS was 90% for malignancy in our centre. There was significant delay to undergo radial-EBUS bronchoscopy with average waiting periods being 17.64 days as compared to local target of 7 days.

Conclusions: The audit showed excellent diagnostic yields from r-EBUS for lung cancer in our centre which minimises the need for further invasive procedures. However, our patients are waiting longer than our local targets to undergo the procedures. There is a need to streamline the referral process as more than half of the patients did not require R-EBUS and almost a quarter had endobronchial lesions.