scholarly journals Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5751
Author(s):  
Takayasu Ito ◽  
Shotaro Okachi ◽  
Tomoki Kimura ◽  
Kensuke Kataoka ◽  
Yasuhiko Suzuki ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Diagnostic Yield ◽  
Transbronchial Biopsy ◽  
Probe Position ◽  
Factors Affecting ◽  
Pulmonary Lesions ◽  
Endobronchial Ultrasonography ◽  
Peripheral Pulmonary Lesions ◽  
Fibrotic Lesion

In patients with interstitial lung disease (ILD), the most frequent locations of lung cancer are within or near fibrotic lesions. However, the diagnostic yield for peripheral pulmonary lesions (PPLs) within or near fibrotic lesions using endobronchial ultrasonography with a guide sheath transbronchial biopsy (EBUS-GS TBB) may be unsatisfactory compared to that for PPLs distant from fibrotic lesions because of the difficulty in reaching the lesions. Our objectives were to evaluate the yield for PPLs using EBUS-GS TBB according to the proximity of PPLs to fibrotic lesions and to determine factors affecting the yield for PPLs. We retrospectively investigated 323 consecutive lesions using EBUS-GS TBB between 1 November 2014 and 31 December 2016. We identified PPLs with ILD in such lesions. PPLs with ILD were divided into PPLs within or near fibrotic lesions which met the criterion of PPLs, and of fibrotic lesions overlapping each other (PPLs-FL) and those distant from fibrotic lesions, which met the criterion of PPLs and the area of fibrotic lesion not overlapping each other (PPLs-NFL). Of the 323 lesions, 55 were included (31 PPLs-FL and 24 PPLs-NFL). The diagnostic yield for PPLs-FL was significantly lower than for PPLs-NFL (45.2% vs. 83.3%, p = 0.004). Multivariate analysis revealed that PPLs-NFL (odds ratio (OR) = 7.509) and a probe position within the lesion (OR = 4.172) were significant factors affecting diagnostic yield. Lesion’s positional relation to fibrotic lesions and the probe position were important factors affecting the successful diagnosis via EBUS-GS TBB in these patients.

scholarly journals A Pilot Study of Transbronchial Biopsy Using Endobronchial Ultrasonography with a Guide Sheath in the Diagnosis of Peripheral Pulmonary Lesions in Patients with Interstitial Lung Disease

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2269
Author(s):  
Takayasu Ito ◽  
Tomoki Kimura ◽  
Kensuke Kataoka ◽  
Shotaro Okachi ◽  
Keiko Wakahara ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Diagnostic Yield ◽  
Transbronchial Biopsy ◽  
Consecutive Series ◽  
Complication Rates ◽  
Pulmonary Lesions ◽  
Endobronchial Ultrasonography ◽  
Peripheral Pulmonary Lesions

The occurrence of interstitial lung disease (ILD) with peripheral pulmonary lesions (PPLs) is closely linked to the development of lung cancer. Yet, the best diagnostic approach for identifying PPLs in patients with ILD remains elusive. This study retrospectively investigated the application of transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS) to the effective and safe diagnosis of PPLs when compared with conventional TBB. The study sample included a consecutive series of 19 patients with ILD who underwent conventional TBB or TBB using EBUS-GS at Tosei General Hospital between 1 April 2013 and 31 October 2015. The two techniques were compared based on diagnostic yield and associated complications. The diagnostic yield of EBUS-GS TBB was significantly higher than that of conventional TBB (p = 0.009), especially for small lesions (≤20 mm), lesions located in the lower lobes, lesions with a positive bronchus sign, and lesions visible by chest radiography (p = 0.010, p = 0.022, p = 0.006, and p = 0.002, respectively). There were no significant differences in complication rates. Therefore, EBUS-GS is an effective alternative for the diagnosis of PPLs in patients with ILD, without additional complications.

scholarly journals Transbronchial Biopsy Using Endobronchial Ultrasonography with a Guide Sheath Increased the Diagnostic Yield of Peripheral Pulmonary Lesions

2012 ◽  
Vol 51 (5) ◽  
pp. 455-460 ◽  
Author(s):  
Masayuki Ishida ◽  
Motoi Suzuki ◽  
Akitsugu Furumoto ◽  
Yoshiko Tsuchihashi ◽  
Koya Ariyoshi ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Transbronchial Biopsy ◽  
Pulmonary Lesions ◽  
Endobronchial Ultrasonography ◽  
Peripheral Pulmonary Lesions

Factors Related to Diagnostic Yield of Transbronchial Biopsy Using Endobronchial Ultrasonography With a Guide Sheath in Small Peripheral Pulmonary Lesions

CHEST Journal ◽  
2007 ◽  
Vol 132 (2) ◽  
pp. 603-608 ◽  
Author(s):  
Noriyuki Yamada ◽  
Koichi Yamazaki ◽  
Noriaki Kurimoto ◽  
Hajime Asahina ◽  
Eiki Kikuchi ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Transbronchial Biopsy ◽  
Pulmonary Lesions ◽  
Endobronchial Ultrasonography ◽  
Peripheral Pulmonary Lesions

scholarly journals Cone-Beam Computed Tomography-Derived Augmented Fluoroscopy Improves the Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Biopsy for Peripheral Pulmonary Lesions

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 41
Author(s):  
Ching-Kai Lin ◽  
Hung-Jen Fan ◽  
Zong-Han Yao ◽  
Yen-Ting Lin ◽  
Yueh-Feng Wen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Success Rate ◽  
Diagnostic Yield ◽  
Study Groups ◽  
Transbronchial Biopsy ◽  
Endobronchial Ultrasound ◽  
Cone Beam ◽  
Ultrasound Guided ◽  
Pulmonary Lesions ◽  
Peripheral Pulmonary Lesions

Background: Endobronchial ultrasound-guided transbronchial biopsy (EBUS-TBB) is used for the diagnosis of peripheral pulmonary lesions (PPLs), but the diagnostic yield is not adequate. Cone-beam computed tomography-derived augmented fluoroscopy (CBCT-AF) can be utilized to assess the location of PPLs and biopsy devices, and has the potential to improve the diagnostic accuracy of bronchoscopic techniques. The purpose of this study was to verify the contribution of CBCT-AF to EBUS-TBB. Methods: Patients who underwent EBUS-TBB for diagnosis of PPLs were enrolled. The navigation success rate and diagnostic yield were used to evaluate the effectiveness of CBCT-AF in EBUS-TBB. Results: In this study, 236 patients who underwent EBUS-TBB for PPL diagnosis were enrolled. One hundred fifteen patients were in CBCT-AF group and 121 were in non-AF group. The navigation success rate was significantly higher in the CBCT-AF group (96.5% vs. 86.8%, p = 0.006). The diagnostic yield was even better in the CBCT-AF group when the target lesion was small in size (68.8% vs. 0%, p = 0.026 for lesions ≤10 mm and 77.5% vs. 46.4%, p = 0.016 for lesions 10–20 mm, respectively). The diagnostic yield of the two study groups became similar when the procedures with a failure of navigation were excluded. The procedure-related complication rate was similar between the two study groups. Conclusion: CBCT-AF is safe, and effectively enhances the navigation success rate, thereby increasing the diagnostic yield of EBUS-TBB for PPLs.

scholarly journals Radial endobronchial ultrasound-guided transbronchial biopsy for peripheral pulmonary malignancy: biopsy- or brushing-first?

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chun-Ta Huang ◽  
Yi-Ju Tsai ◽  
Chao-Chi Ho ◽  
Chong-Jen Yu
Keyword(s):  
Diagnostic Yield ◽  
Transbronchial Biopsy ◽  
Endobronchial Ultrasound ◽  
Current Evidence ◽  
Diagnostic Strategy ◽  
Safety Signal ◽  
Pulmonary Lesions ◽  
Bronchial Brushing ◽  
Peripheral Pulmonary Lesions ◽  
The Impact

Abstract Background Radial endobronchial ultrasound (R-EBUS)-guided transbronchial biopsy (TBB) is a common diagnostic modality for peripheral pulmonary lesions; however, there is uncertainty about the optimal sequence of TBB and bronchial brushing during the procedure. Thus, we aimed to investigate whether a biopsy-first or brushing-first strategy confers a better diagnostic yield and safety signal for R-EBUS-guided procedures for peripheral pulmonary malignancy. Methods From January 2017 to June 2018, consecutive patients referred for R-EBUS-guided TBB and bronchial brushing of peripheral pulmonary lesions and with a final malignant diagnosis were included. Patients were placed in a biopsy-first (biopsy followed by brushing) or a brushing-first (brushing followed by biopsy) group. The outcomes of interest were the diagnostic yield and complication profile of the procedures. Multivariate logistic regression and subgroup analysis were used to assess the impact of the procedure strategy. Results A total of 438 patients were included and the diagnostic yield of R-EBUS-guided TBB plus brushing for peripheral pulmonary malignancy was 73%. The diagnostic yield was associated with the solid lesion appearance (odds ratio [OR] 2.01; 95% confidence interval [CI] 1.08–3.75) and R-EBUS probe position within the lesion (OR 1.92; 95% CI 1.08–3.42), and the yield rates were comparable between the biopsy-first and brushing-first strategies. Moreover, the safety signal did not differ between the two groups. Conclusions The two procedure strategies were indistinguishable in terms of diagnostic efficacy and adverse events for patients with peripheral pulmonary malignancy. Current evidence indicates that in patients with peripheral pulmonary lesions suspected of being malignant, either biopsy-first or brushing-first is a viable and acceptable diagnostic strategy during R-EBUS-guided procedures.

Diagnostic yield of combined bronchoscopy and endobronchial ultrasonography, under LungPoint guidance for small peripheral pulmonary lesions

Respirology ◽  
2013 ◽  
Vol 18 (5) ◽  
pp. 834-839 ◽  
Author(s):  
Motohiro Tamiya ◽  
Norio Okamoto ◽  
Shinji Sasada ◽  
Takayuki Shiroyama ◽  
Naoko Morishita ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Pulmonary Lesions ◽  
Endobronchial Ultrasonography ◽  
Peripheral Pulmonary Lesions

Guide sheath versus non-guide sheath method for endobronchial ultrasound-guided biopsy of peripheral pulmonary lesions: A multicenter randomized trial

2021 ◽  
pp. 2101678
Author(s):  
Masahide Oki ◽  
Hideo Saka ◽  
Tatsuya Imabayashi ◽  
Daisuke Himeji ◽  
Yoichi Nishii ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Primary Endpoint ◽  
Diagnostic Yield ◽  
Transbronchial Biopsy ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Pulmonary Lesions ◽  
Multicenter Randomized Trial ◽  
Median Diameter ◽  
Peripheral Pulmonary Lesions

IntroductionGuide sheaths (GSs) have been widely used during radial probe endobronchial ultrasound-guided transbronchial biopsy (rEBUS-TBB) of peripheral pulmonary lesions. However, it remains unknown whether a GS enhances the diagnostic yield. We compared the diagnostic yields of small peripheral pulmonary lesions between rEBUS-TBB with and without a GS.MethodsIn eight institutions, patients with peripheral pulmonary lesions≤30 mm in diameter were enrolled and randomized to undergo rEBUS-TBB with a GS (GS group) or without a GS (non-GS group) using a 4.0-mm thin bronchoscope, virtual bronchoscopic navigation, and fluoroscopy. The primary endpoint was the diagnostic yield of the histology specimens.ResultsA total of 605 patients were enrolled; ultimately, data on 596 (300 in the GS group and 296 in the non-GS group) with peripheral pulmonary lesions having a longest median diameter of 19.6 mm were analyzed. The diagnostic yield of histological specimens from the GS group was significantly higher than that from the non-GS group (55.3% versus 46.6%, respectively; p=0.033). Interactions were evident between the diagnostic yields, procedures, lobar locations (upper lobe versus other regions, p=0.003), and lesion texture (solid versus part-solid nodules, p=0.072).ConclusionsThe diagnostic yield for small peripheral pulmonary lesions afforded by rEBUS-TBB using a GS was higher than that without a GS.

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