Diagnostic utility and accuracy of rapid on-site evaluation of bronchoscopic brushings

The aim of the study was to determine the accuracy of rapid on-site examinations, performed on transbronchial brushings of peripheral pulmonary lesions, in determining final bronchoscopic diagnosis. In addition to determining if rapid on-site examination impacts procedural outcomes.A prospective cohort study of consecutive patients with peripheral pulmonary lesions, which had been located by radial endobronchial ultrasound, was undertaken. Bronchoscopy was terminated if rapid on-site examination demonstrated diagnostic malignant material. Non-diagnostic rapid on-site examination resulted in further bronchoscopic sampling, including transbronchial lung biopsy and/or sampling from different locations.128 peripheral pulmonary lesions were located by endobronchial ultrasound in 118 patients. The final bronchoscopic diagnoses included nonsmall cell lung cancer (n=76), carcinoid (n=3), and metastatic malignancy (n=3). Procedure times were significantly shorter for procedures when rapid on-site examinations demonstrated malignancy compared to those where rapid on-site examination was non-diagnostic (19±8 min versus 31±11 min, respectively; p<0.0001). In four procedures, initial negative rapid on-site examination results prompted redirection of sampling from alternate bronchial segments, resulting in positive diagnostic tissue being obtained. Positive and negative predictive value of rapid on-site examination for a malignant bronchoscopic diagnosis was 63 (97%) out of 65, and 43 (68%) out of 63, respectively.Rapid on-site examination of brushing specimens has a very high, positive, predictive value for bronchoscopic diagnosis of cancer and shortens the bronchoscopy procedure times. It has the potential to reduce complications, improve cost-effectiveness, and may improve diagnostic performance via live feedback.

Download Full-text

Diagnostic value of rapid on‐site evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions

Cytopathology ◽

10.1111/cyt.12776 ◽

2019 ◽

Vol 31 (1) ◽

pp. 16-21

Author(s):

Tao Wan ◽

Yishi Li ◽

Qianfang Hu ◽

Hongli Deng ◽

Dairong Li

Keyword(s):

Diagnostic Value ◽

Endobronchial Ultrasound ◽

Pulmonary Lesions ◽

Site Evaluation ◽

Peripheral Pulmonary Lesions

Download Full-text

Diagnostic value of endobronchial ultrasound combined with rapid on‐site evaluation of transbronchial lung biopsy for peripheral pulmonary lesions

Diagnostic Cytopathology ◽

10.1002/dc.24725 ◽

2021 ◽

Author(s):

Chunhua Xu ◽

Wei Liu ◽

Wei Wang ◽

Li Li ◽

Huidi Hu ◽

...

Keyword(s):

Lung Biopsy ◽

Diagnostic Value ◽

Transbronchial Lung Biopsy ◽

Endobronchial Ultrasound ◽

Pulmonary Lesions ◽

Site Evaluation ◽

Peripheral Pulmonary Lesions

Download Full-text

Rapid On-Site Evaluation During Radial Endobronchial Ultrasound–Guided Transbronchial Lung Biopsy for the Diagnosis of Peripheral Pulmonary Lesions

Technology in Cancer Research & Treatment ◽

10.1177/1533033820947482 ◽

2020 ◽

Vol 19 ◽

pp. 153303382094748

Author(s):

Chunhua Xu ◽

Wei Wang ◽

Qi Yuan ◽

Huidi Hu ◽

Li Li ◽

...

Keyword(s):

Lung Biopsy ◽

Malignant Tumors ◽

Diagnostic Yield ◽

Operation Time ◽

Transbronchial Lung Biopsy ◽

Endobronchial Ultrasound ◽

Benign Lesions ◽

Pulmonary Lesions ◽

Site Evaluation ◽

Peripheral Pulmonary Lesions

Objective: To evaluate the diagnostic value of radial endobronchial ultrasound (R-EBUS) combination with rapid on-site evaluation (ROSE) guided transbronchial lung biopsy (TBLB) for peripheral pulmonary lesions. Methods: Peripheral pulmonary lesions identified by computed tomography underwent R-EBUS with or without ROSE randomly from February 2016 to August 2017. The diagnostic yield and the operation time were compared. Results: In total, 158 patients were involved in and completed this research, including 84 cases in the group of R-EBUS with ROSE, and 74 in the group without ROSE. The diagnostic yield of ROSE group was 85.7%. Among these positive cases, 69.4% cases were malignant tumors, and 30.6% cases were benign lesions. The operation time was (24.6 ± 6.3) min. In the group without ROSE, the diagnostic yield was 70.3%, including 35 malignant tumors (67.3%), and 17 benign lesions (32.7%). The operation time was (31.5 ± 6.8) min. There were significant differences between both groups in the diagnostic yield (χ2 = 5.556, P = 0.018) and in the operation time (t = 3.187, P < 0.01). No serious procedure related complications were observed, such as pneumothorax and hemorrhage. Conclusion: ROSE can improve the diagnostic yield, and shorten the operation time. R-EBUS combined with ROSE is a safe and effective technique for peripheral pulmonary lesions.

Download Full-text

Combination of virtual bronchoscopic navigation, endobronchial ultrasound, and rapid on-site evaluation for diagnosing small peripheral pulmonary lesions: a prospective phase II study

Journal of Thoracic Disease ◽

10.21037/jtd.2017.06.85 ◽

2017 ◽

Vol 9 (7) ◽

pp. 1930-1936 ◽

Cited By ~ 5

Author(s):

Toshiya Maekura ◽

Chikatoshi Sugimoto ◽

Akihiro Tamiya ◽

Nobuhiko Saijo ◽

Yoko Naoki ◽

...

Keyword(s):

Phase Ii ◽

Phase Ii Study ◽

Endobronchial Ultrasound ◽

Pulmonary Lesions ◽

Prospective Phase ◽

Site Evaluation ◽

Peripheral Pulmonary Lesions

Download Full-text

Improved diagnostic yield of transbronchial lung biopsy in peripheral pulmonary lesions using a combination of endobronchial ultrasound and rapid on-site evaluation

Journal of International Medical Research ◽

10.1177/0300060521999535 ◽

2021 ◽

Vol 49 (3) ◽

pp. 030006052199953

Author(s):

Chunhua Xu ◽

Yan Wang ◽

Wei Wang ◽

Qi Yuan ◽

Hui di Hu ◽

...

Keyword(s):

Lung Biopsy ◽

Diagnostic Yield ◽

Transbronchial Lung Biopsy ◽

Endobronchial Ultrasound ◽

Procedure Time ◽

Cytologic Diagnosis ◽

Pulmonary Lesions ◽

Procedural Complications ◽

Site Evaluation ◽

Peripheral Pulmonary Lesions

Objectives To evaluate the value of rapid on-site evaluation (ROSE) during radial probe endobronchial ultrasound transbronchial lung biopsy (rpEBUS-TBLB) for peripheral pulmonary lesions (PPLs). Methods One hundred and six patients with PPLs who received rpEBUS-TBLB were enrolled in this study. One specimen was immediately examined by ROSE and the other was sent to the central laboratory for cytologic diagnosis. The results of ROSE were compared with those of pathological diagnosis. Results The diagnostic accuracy, sensitivity, and specificity of ROSE during rpEBUS-TBLB for PPLs were 82.1%, 89.6%, and 77.1%, respectively. The procedure times and number of biopsies were less for procedures when ROSE was positive compared with those when ROSE was negative (procedure time: 20.5 ± 7.9 vs. 28.3 ± 7.6 minutes; number of biopsies: 1.6 ± 0.9 vs. 2.8 ± 0.6 times). No serious procedural complications were observed. Conclusions ROSE has value for diagnosing PPLs during rpEBUS. It can reduce procedure time, number of biopsies, and complications. ROSE combined with rpEBUS is an effective and safe method for the diagnosis of PPLs.

Download Full-text

Faculty Opinions recommendation of Radial endobronchial ultrasound for the diagnosis of peripheral pulmonary lesions: A systematic review and meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727290231.793551451 ◽

2018 ◽

Author(s):

Elaine Dumoulin

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Endobronchial Ultrasound ◽

Pulmonary Lesions ◽

Peripheral Pulmonary Lesions

Download Full-text

Efficacy and Safety of Cone-Beam Computed Tomography-Derived Augmented Fluoroscopy Combined with Endobronchial Ultrasound in Peripheral Pulmonary Lesions

Respiration ◽

10.1159/000515181 ◽

2021 ◽

pp. 1-9

Author(s):

Kai-Lun Yu ◽

Shun-Mao Yang ◽

Huan-Jang Ko ◽

Hui-Yu Tsai ◽

Jen-Chung Ko ◽

...

Keyword(s):

Computed Tomography ◽

Propensity Score ◽

Cone Beam Computed Tomography ◽

Diagnostic Yield ◽

Endobronchial Ultrasound ◽

Cone Beam ◽

Complication Rates ◽

Efficacy And Safety ◽

Pulmonary Lesions ◽

Peripheral Pulmonary Lesions

Background: The diagnostic yield of peripheral pulmonary lesions (PPLs) using radial endobronchial ultrasound (EBUS) remains challenging without navigation systems. Cone-beam computed tomography-derived augmented fluoroscopy (CBCT-AF) represents a recently developed technique, and its clinical utility remains to be investigated. Objectives: The aim of this study was to investigate the diagnostic yield of transbronchial biopsy (TBB) using a combination of CBCT-AF and radial EBUS. Methods: We recruited consecutive patients with PPLs who underwent radial EBUS-guided TBB, with or without AF, between October 2018 and July 2019. Following propensity score 1:1 matching, we recorded the procedure-related data and measured their efficacy and safety. Results: While 72 patients received EBUS-plus-AF, 235 patients received EBUS only. We included 53 paired patients following propensity score matching. The median size of lesions was 2.8 and 2.9 cm in the EBUS-plus-AF group and EBUS-only group, respectively. Diagnostic yield was higher in the former group (75.5 vs. 52.8%; p = 0.015). The diagnostic yield for the EBUS-plus-AF group was significantly higher for lesions ≤30 mm (73.5 vs. 36.1%; p = 0.002). Moreover, there was no significant difference in the complication rates (3.8 vs. 5.7%; p = 1.000). Twenty-four nodules (45.3%) were invisible by fluoroscopy in the EBUS-plus-AF group. All of them were identifiable on CBCT images and successfully annotated for AF. The mean radiation dose of total procedure, CBCT, and fluoroscopy was 19.59, 16.4, and 3.17 Gy cm2, respectively. Conclusions: TBB using a combination of CBCT-AF and EBUS resulted in a satisfactory diagnostic yield and safety.

Download Full-text