The Value of Additional Conventional Transbronchial Biopsy in the Negative Results of Rapid On-site Evaluation During Endobronchial Ultrasound With Guide Sheath to Diagnose Small Peripheral Lung Cancer

Objective: The accuracy of rapid on-site evaluation (ROSE) during endobronchial ultrasonography with guide sheath (EBUS-GS) was reported to be approximately 90% for diagnosing small peripheral pulmonary lesions (PPLs). When ROSE during EBUS-GS for diagnosing small peripheral lung cancer is carried out and does not include malignant cells in a position whereby the probe was located within or adjacent to the lesion, the best technique for overcoming the lower diagnostic yield remains unknown. This study aimed to evaluate factors affecting positive results of ROSE during EBUS-GS in such a probe position. Moreover, when the results of ROSE were consistently negative, we evaluated the effectiveness of conventional transbronchial biopsy (TBB) in addition to EBUS-GS alone. Methods: We performed a retrospective analysis of consecutive patients who underwent EBUS-GS combined with ROSE for diagnosing small peripheral lung cancer (≤30 mm). We classified the results of ROSE into two groups based on the presence of malignant cells: the ROSE positive group (included malignant cells) and the ROSE negative group (did not include malignant cells). The significant predictors of positive ROSE results during EBUS-GS were analyzed using multivariate logistic regression analyses. Results: We identified 67 lesions (43 lesions in the ROSE positive group and 24 lesions in the ROSE negative group, respectively). Multivariate logistic analysis revealed that the significant factor affecting positive ROSE results was lesion size (>15 mm) (OR = 9.901). The diagnostic yield of additional conventional TBB to EBUS-GS was significantly higher than that of EBUS-GS alone (75.0% vs 33.3%, P = .041). Conclusion: The positive results of ROSE during EBUS-GS were significantly influenced by lesion size (>15 mm). When the results of ROSE during EBUS-GS were consistently negative in a position whereby the probe was located within or adjacent to the lesion, additional conventional TBB was effective to improve the diagnostic yield compared with EBUS-GS alone.

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Factors Associated with Diagnostic Yield of Endobronchial Ultrasonography with a Guide Sheath for Peripheral Lung Cancer

Journal of UOEH ◽

10.7888/juoeh.38.17 ◽

2016 ◽

Vol 38 (1) ◽

pp. 17-23 ◽

Cited By ~ 2

Author(s):

Keigo UCHIMURA ◽

Kei YAMASAKI ◽

Hiroshi ISHIMOTO ◽

Sho KAKINOUCHI ◽

Koki KIMURA ◽

...

Keyword(s):

Lung Cancer ◽

Diagnostic Yield ◽

Peripheral Lung Cancer ◽

Factors Associated ◽

Endobronchial Ultrasonography ◽

Peripheral Lung

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Diagnostic value of rapid on-site evaluation during transbronchial biopsy for peripheral lung cancer

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyz025 ◽

2019 ◽

Vol 49 (6) ◽

pp. 501-505 ◽

Cited By ~ 2

Author(s):

Juan Wang ◽

Yaping Zhao ◽

Qianqian Chen ◽

Peng Zhang ◽

Wei Xie ◽

...

Keyword(s):

Lung Cancer ◽

Diagnostic Value ◽

Transbronchial Biopsy ◽

Peripheral Lung Cancer ◽

Peripheral Lung ◽

Site Evaluation

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Preoperative procedures in diagnosis of central and peripheral lung cancer

Acta chirurgica iugoslavica ◽

10.2298/aci0603035m ◽

2006 ◽

Vol 53 (3) ◽

pp. 35-39

Author(s):

D. Mandaric ◽

D. Stojiljkovic ◽

N. Miletic ◽

M. Inic ◽

J. Djordjevic

Keyword(s):

Lung Cancer ◽

Percutaneous Biopsy ◽

Fine Needle Biopsy ◽

Actual Problem ◽

Forceps Biopsy ◽

Fine Needle ◽

Peripheral Lung Cancer ◽

Clinical Center ◽

Peripheral Lung ◽

Positive Results

Background: Actual problem in diagnostics and therapy of lung cancer is early diagnostic and choice of diagnostic procedure. The aim of this work was to assess the sensitivity of various histocytologic methods in diagnosis of central and peripheral lung cancer lesions. Material and methods: During 2003-2004, 348 patients with lung infiltrates suspect for malignancy were treated in University of Kragujevac Clinical Center. For the preoperative diagnostics, their sputum, bronchoaspirate, aspirate obtained by fine needle percutaneous biopsy and specimens obtained by forceps biopsy during fiberbronchoscopy were analyzed using standard cytohistology methods. RESULTS: Lung cancer was diagnosed in 155 out of 348 patients. The malignant lesions were centrally located in 123 patients (79,4%), while peripheral localization was found in 32 patients (20,6%). In the former patients, forceps biopsy was positive in 89,4%, and when combined with bronchoaspirate analysis, positive results were obtained in 91,9% of patients. In patients with peripherally located lesions, fine needly biopsy was positive in 68,8%, while citological analysis of sputum and bronchoalveolar aspirate were positive in only three (9,4%) patients. When all three methods were combined, positive results were found in 25 (78,1%) patients. Conclusion: The central localization of tumors was four times greater than the peripheral one. In the patients with central tumour site, the best results were obtained when forceps biopsy specimens and sputum were analysed cytologically. The combination of transcutaneous fine-needle biopsy, bronchoscopy and sputum gave the best results in the group of patients whose lesions were located peripherally. .

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18F-FDG uptake predicts diagnostic yield of transbronchial biopsy in peripheral lung cancer

Lung Cancer ◽

10.1016/j.lungcan.2014.03.025 ◽

2014 ◽

Vol 85 (1) ◽

pp. 47-52 ◽

Cited By ~ 5

Author(s):

Yukihiro Umeda ◽

Yoshiki Demura ◽

Masaki Anzai ◽

Hiroki Matsuoka ◽

Tomoyuki Araya ◽

...

Keyword(s):

Lung Cancer ◽

Diagnostic Yield ◽

Transbronchial Biopsy ◽

Peripheral Lung Cancer ◽

Fdg Uptake ◽

Peripheral Lung ◽

18F Fdg

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The diagnosis value of endobronchial ultrasound transbronchial lung biopsy combined with rapid on‐site evaluation in peripheral lung cancer

The Clinical Respiratory Journal ◽

10.1111/crj.13151 ◽

2020 ◽

Vol 14 (5) ◽

pp. 447-452 ◽

Cited By ~ 2

Author(s):

Chun Hua Xu ◽

Ji Wang Wang ◽

Wei Wang ◽

Qi Yuan ◽

Yu Chao Wang ◽

...

Keyword(s):

Lung Cancer ◽

Lung Biopsy ◽

Transbronchial Lung Biopsy ◽

Endobronchial Ultrasound ◽

Peripheral Lung Cancer ◽

Peripheral Lung ◽

Site Evaluation

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Factors Affecting the Diagnostic Yield of Transbronchial Biopsy Using Endobronchial Ultrasonography with a Guide Sheath in Peripheral Lung Cancer

Internal Medicine ◽

10.2169/internalmedicine.55.6341 ◽

2016 ◽

Vol 55 (13) ◽

pp. 1705-1712 ◽

Cited By ~ 9

Author(s):

Shotaro Okachi ◽

Naoyuki Imai ◽

Kazuyoshi Imaizumi ◽

Shingo Iwano ◽

Masahiko Ando ◽

...

Keyword(s):

Lung Cancer ◽

Diagnostic Yield ◽

Transbronchial Biopsy ◽

Factors Affecting ◽

Peripheral Lung Cancer ◽

Endobronchial Ultrasonography ◽

Peripheral Lung

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CT Signs and Differential Diagnosis of Peripheral Lung Cancer and Inflammatory Pseudotumor: A Meta-Analysis

Journal of Healthcare Engineering ◽

10.1155/2022/3547070 ◽

2022 ◽

Vol 2022 ◽

pp. 1-11

Author(s):

Shiyi Zheng ◽

Jie Shu ◽

Jianan Xue ◽

Caiyun Ying

Keyword(s):

Lung Cancer ◽

Inflammatory Pseudotumor ◽

Meta Analysis ◽

Statistical Significance ◽

Lesion Size ◽

Cochrane Library ◽

Peripheral Lung Cancer ◽

Enhanced Ct ◽

Peripheral Lung ◽

The Difference

We aimed to systematically evaluate the imaging features of peripheral lung cancer and inflammatory pseudotumor. PubMed, Embase, Cochrane Library, Chinese Knowledge Infrastructure (CNKI), Wanfang database (Wanfang), and Chinese Biomedical Network (CBM) were searched to collect relevant studies on CT image comparison of peripheral lung cancer and inflammatory pseudotumor. The search time was from database establishment to July 15, 2021. The search language was limited to Chinese and English. Data from the literature were screened and extracted, and meta-analysis was performed using Stata 16.0 software. A total of 8 cohort studies were included in this meta-analysis, including 675 patients. Meta-analysis showed that the lesion size of inflammatory pseudotumor was greater than that of peripheral lung cancer, and the difference had statistical significance [SMD = 0.29, 95% CI (0.01, 0.58), P < 0.05 ]. The difference in HU value between inflammatory pseudotumor and peripheral lung cancer CT had no statistical significance [SMD = −0.09, 95% CI (−0.79, 0.60), P > 0.05 ]. The HU value of enhanced CT of inflammatory pseudotumor was higher than that of peripheral lung cancer, and the difference had statistical significance [SMD = 0.75, 95% CI (0.15, 1.34), P < 0.05 ]. The incidence of calcification of inflammatory pseudotumor was significantly higher than that of peripheral lung cancer, and the difference had statistical significance [RR = 2.85, 95% CI (1.33, 6.11), P < 0.05 ]. The incidence of long hair puncture sign of inflammatory pseudotumor was lower than that of peripheral lung cancer, and the difference had statistical significance [RR = 0.49, 95% CI (0.24, 0.97), P < 0.05 ]. There was no significant difference between inflammatory pseudotumor and peripheral lung cancer in terms of cavity incidence, vacuole sign, pleural indentation, and bronchial inflation sign ( P > 0.05 ). Based on the available literature evidence, it can be found that there are differences in the CT signs between peripheral lung cancer and inflammatory pseudotumor, and the lesion size, HU value on enhanced CT, incidence of calcification, and incidence of burr sign may be important indicators for differentiating peripheral lung cancer from inflammatory pseudotumor.

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