| Institution: | 1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand;2. Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand;1. Okinawa Nanbu Regional Center for Children with Special Needs, Okinawa, Japan;2. Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan;1. Section of Thoracic Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH;2. Cardiovascular Imaging Laboratory, Imaging Institute, Cleveland Clinic, Cleveland, OH;1. Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan;2. Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan;5. Thoracic Surgery, Fukuoka University School of Medicine, Fukuoka, Japan;3. Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Fukuoka, Japan;4. Department of Human Pathology, Tokyo Medical and Dental University, Graduate School and Faculty of Medicine, Tokyo, Japan;6. Department of Respiratory Medicine, Nishi Fukuoka Hospital, Fukuoka, Japan;1. Jichi Medical University, Center of Community Medicine, Tochigi, Japan;2. Nagoya City University Graduate School of Medicine, Department of Community-based Medical Education, Aichi, Japan;3. Yurin Hospital, Tokyo, Japan;4. Waseda University, Regional and Inter-Regional Studies, Tokyo, Japan |
| Abstract: | BackgroundData regarding the transbronchial biopsy (TBB) techniques in radial endobronchial ultrasound (R-EBUS)-guided bronchoscopy are limited. The purpose of this study was to compare three R-EBUS-guided TBB techniques for the diagnosis of peripheral pulmonary lesions (PPLs).MethodsA prospective pilot study was conducted including 90 patients with positive bronchus sign PPLs, who underwent R-EBUS-guided TBB. TBB techniques were performed in all patients using small biopsy forceps with a guide sheath (GS). These samples were submitted for both cell block histology (CB) and conventional histology (SB). Standard biopsy forceps were used to collect further samples that were submitted for conventional histology (LB). The diagnostic yields of the three techniques were compared.ResultsThe mean diameter of the PPLs was 25.5 ± 8.2 mm and the final diagnoses included 70 malignant and 20 benign lesions. The overall diagnostic yield of R-EBUS-guided bronchoscopy was 82.2%. Although the difference was not statistically significant, CB provided the highest yield of the three TBB techniques: 68.9%, 65.6%, and 62.2% for CB, SB, and LB, respectively (P = 0.20). When the GS was removed and standard biopsy forceps were introduced, misplacement (detected by fluoroscopy) was observed in 24 cases, and LB provided a diagnosis in 11 cases. PPLs ≤20 mm were associated with misplacement (P = 0.003). After the exclusion of misplaced cases, the diagnostic yields were 69.7%, 71.2%, and 68.2% for CB, SB, and LB, respectively (P = 0.65).ConclusionsNeither the size of biopsy forceps nor the histology process affected the diagnostic yield of R-EBUS-guided bronchoscopy. |
