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 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 Safety and Usefulness of Cryobiopsy and Stamp Cytology for the Diagnosis of Peripheral Pulmonary Lesions

Cancers ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 410 ◽  
Author(s):  
Tatsuya Imabayashi ◽  
Junji Uchino ◽  
Akihiro Yoshimura ◽  
Yusuke Chihara ◽  
Nobuyo Tamiya ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Diagnostic Yield ◽  
Diagnostic Technique ◽  
Histological Diagnosis ◽  
Tissue Samples ◽  
Pulmonary Lesions ◽  
Lung Cancer Diagnosis ◽  
Thoracic Drainage ◽  
Endobronchial Ultrasonography ◽  
Peripheral Pulmonary Lesions

Reports on the use of cryobiopsy (CB) for lung cancer diagnosis are limited. The aims of the present study were to evaluate the safety and usefulness of CB using radial endobronchial ultrasonography, without a guide sheath, for the diagnosis of peripheral pulmonary lesions and determine the utility of stamp cytology, an on-site diagnostic technique for determining tumor inclusion in CB samples. We retrospectively analyzed data for 35 patients (36 lesions) with suspected peripheral lung cancer who underwent CB between August 2017 and February 2019 at our medical facility. The diagnostic yield, incidence of complications, and the utility of stamp cytology for diagnosis were investigated. The diagnostic yield of CB was 86.1% (31/36) with histological diagnosis, and 80.5% (29/36) with diagnosis using stamp cytology; the overall yield was 91.6% (33/36). Pneumothorax requiring thoracic drainage occurred in two patients, both of whom had lesions contacting the pleura. Grade 2 and grade 1 bleeding occurred in one and 25 patients, respectively. CB enables the collection of very large, nearly intact tissue samples, thus resulting in an improvement in the true diagnosis rate and facilitating the measurement of multiple biomarkers as well as rapid histological diagnosis.

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

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

Respiration ◽  
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

<b><i>Background:</i></b> 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. <b><i>Objectives:</i></b> The aim of this study was to investigate the diagnostic yield of transbronchial biopsy (TBB) using a combination of CBCT-AF and radial EBUS. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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%; <i>p</i> = 0.015). The diagnostic yield for the EBUS-plus-AF group was significantly higher for lesions ≤30 mm (73.5 vs. 36.1%; <i>p</i> = 0.002). Moreover, there was no significant difference in the complication rates (3.8 vs. 5.7%; <i>p</i> = 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 cm<sup>2</sup>, respectively. <b><i>Conclusions:</i></b> TBB using a combination of CBCT-AF and EBUS resulted in a satisfactory diagnostic yield and safety.

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.

scholarly journals The utility of transbronchial rebiopsy for peripheral pulmonary lesions in patients with advanced non-squamous non-small cell lung cancer

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Akiko Tateishi ◽  
Yuji Matsumoto ◽  
Midori Tanaka ◽  
Toshiyuki Nakai ◽  
Shinji Sasada ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Diagnostic Yield ◽  
Small Cell ◽  
Endobronchial Ultrasound ◽  
Small Cell Lung ◽  
Molecular Analyses ◽  
Pulmonary Lesions ◽  
Initial Biopsy ◽  
Peripheral Pulmonary Lesions

Abstract Background Patients treated for non-squamous (non-Sq) non-small cell lung cancer (NSCLC) often require repeat biopsies to determine the optimal subsequent treatment. However, the differences between rebiopsy and initial biopsy in terms of their diagnostic yields and their ability to test the molecular profiles using bronchoscopy with radial endobronchial ultrasound guidance in patients with advanced NSCLC remain unclear. Hence, we aimed to compare the diagnostic yields and ability for molecular analyses of rebiopsies with those of initial biopsies. Methods We investigated 301 patients with advanced non-Sq NSCLC who underwent radial endobronchial ultrasound-guided transbronchial biopsy (TBB) for peripheral pulmonary lesions (PPLs) between August 2014 and July 2017. Patients were divided into the rebiopsy and initial biopsy groups: the latter referred to the biopsy that determined the definitive diagnosis. The diagnostic yields and ability for molecular analyses were compared between the two groups, and the factors affecting the TBB diagnostic yield were identified using univariate and multivariate analyses. Results The diagnostic yields of the rebiopsy and initial biopsy groups were comparable (86.8 and 90.8%, respectively; p = 0.287). Furthermore, 93.0 and 94.0% of the patients in the rebiopsy and initial biopsy groups, respectively, had adequate specimens for gene profiling and mutational analysis (p = 0.765). The factors that increased the diagnostic yield were a positive bronchus sign (p < 0.001) and tumour location within the internal two-thirds of the lungs (p = 0.026). Conclusions The PPL diagnostic yield of the rebiopsy group was as high as that of the initial biopsy group. Hence, TBB for PPLs is feasible for patients requiring rebiopsy as well as for those with initial diagnoses. Adequate, high-quality biopsy specimens can be obtained by transbronchial rebiopsy for molecular testing.

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