Cancer Res Treat.  2023 Apr;55(2):506-512. 10.4143/crt.2022.1008.

The Additive Impact of Transbronchial Cryobiopsy Using a 1.1-mm Diameter Cryoprobe on Conventional Biopsy for Peripheral Lung Nodules

• Kim SH
• Mok J
• Jo EJ
• Kim MH
• Lee K
• Kim KU
• Park HK
• Lee MK
• Eom JS

• KMID: 2541237
• DOI: http://doi.org/10.4143/crt.2022.1008

Abstract

Purpose
The diagnostic yield of transbronchial biopsy (TBB) using radial probe endobronchial ultrasound (RP-EBUS) is 71%, which is lower than that of transthoracic needle biopsy. We investigated the performance and safety of sequential transbronchial cryobiopsy (TBC) using a novel 1.1-mm diameter cryoprobe, after conventional TBB using RP-EBUS for the diagnosis of peripheral lung lesions (PLLs).
Materials and Methods
From April 2021 to November 2021, 110 patients who underwent bronchoscopy using RP-EBUS for the diagnosis of PLL ≤ 30 mm were retrospectively included in our study. All records were followed until June 2022.
Results
The overall diagnostic yield of combined TBB and TBC was 79.1%, which was higher than 60.9% of TBB alone (p=0.005). The diagnostic yield of sequential TBC was 65.5%, which increased the overall diagnostic yield by 18.2%. The surface area of tissues by TBC (mean area, 18.5 mm²) was significantly larger than those of TBB by 1.5-mm forceps (3.4 mm², p < 0.001) and 1.9-mm forceps (3.7 mm², p=0.011). In the multivariate analysis, PLLs with the longest diameter of ≤ 22 mm were found to be related to additional diagnostic benefits from sequential TBC (odds ratio, 3.51; 95% confidence interval, 1.043 to 11.775; p=0.042). Complications were found in 10.5% of the patients: pneumothorax (1.0%), infection (1.0%), and significant bleeding (8.6%). None of the patients developed any life-threatening complications.
Conclusion
Sequential TBC with a 1.1-mm cryoprobe improved the performance of conventional TBB using RP-EBUS without serious complications.

Keyword

Bronchoscopy; Diagnosis; Lung neoplasms; Ultrasonography

Figure

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  Fig. 1 Flow diagram of the study patients. EBUS, endobronchial ultrasound; PLL, peripheral lung lesion; TBB, transbronchial biopsy.

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  Fig. 2 Venn diagram of results of the bronchoscopy procedure.

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  Fig. 3 Comparisons of the mean longest diameter (A) and the surface area (B) of tissue between cyobiopsy samples and forceps biopsy samples.

Reference

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