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. 2016 Jan 1;7(1):7-13.
doi: 10.7150/jca.13081. eCollection 2016.

Radial Endobronchial Ultrasound (EBUS) Guided Suction Catheter-Biopsy in Histological Diagnosis of Peripheral Pulmonary Lesions

Bojan Zaric  1 , Vladimir Stojsic  1 , Vladimir Carapic  1 , Tomi Kovacevic  1 , Goran Stojanovic  1 , Milana Panjkovic  1 , Ioannis Kioumis  2 , Kaid Darwiche  3 , Konstantinos Zarogoulidis  2 , Grigoris Stratakos  4 , Drosos Tsavlis  2 , Wolfgang Hohenforst-Schmidt  5 , Georgia Pitsiou  2 , Athanasios Zissimopoulos  6 , Nikos Sachpekidis  7 , Ilias Karapantzos  8 , Chrysanthi Karapantzou  8 , Paul Zarogoulidis  2 , Branislav Perin  1
Affiliations

Radial Endobronchial Ultrasound (EBUS) Guided Suction Catheter-Biopsy in Histological Diagnosis of Peripheral Pulmonary Lesions

Bojan Zaric et al. J Cancer. .

Abstract

Background: EBUS guided trans-bronchial biopsy became routine in diagnosis of peripheral pulmonary lesions (PPL). Suction catheter-biopsy is a technique for obtaining a tissue sample from peripheral lung parenchyma. Aim of this study was to evaluate diagnostic efficiency, feasibility and safety of EBUS guided suction catheter-biopsy (SCB) in comparison to trans-bronchial biopsy (TBB) in diagnosis of PPL. The main intention was to demonstrate non-inferiority of the technique over trans-bronchial biopsy, especially when used under navigation of the EBUS.

Methods: Radial EBUS probe (UM-3R, Olympus Co, Japan.) without guiding sheath was used to navigate suction catheter and TBB forceps to the PPL. The catheter was connected to the collection canister via vacuum pump. The SCB specimens were fixed with 10% buffered formalin.

Results: There were 168 patients enrolled in this study; 69.9% males and 30.1% females. Main lesion diameter was 4.1±1.9 cm. Majority of patients, 131(77.9%) were diagnosed with lung cancer. Per-biopsy calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for EBUS-SCB were 92.4%, 100%, 100% and 67.7%, respectively. Corresponding values for EBUS-TBB were 92.3%, 100%, 100% and 69.7%. Only the size of the lesion significantly influenced (p=0.005) diagnostic performance. Complications occurred in 2 patients; one pneumothorax and one excessive bleeding.

Conclusion: EBUS guided SCB is efficient, feasible and safe in diagnosis of peripheral lung cancer. The technique is complementary to trans-bronchial biopsy.

Keywords: EBUS; bronchoscopy; endobronchial ultrasound; interventional pulmonology, lung cancer; peripheral pulmonary lesion.

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Conflict of interest statement

Conflict of Interest: The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.

Figures

Figure 1
Figure 1
Biopsy equipment
Figure 2
Figure 2
Sample bottle
Figure 3
Figure 3
Biopsy sample, tissue fragments can be seen at the flour of the bottle
Figure 4
Figure 4
Squamus cell carcinoma x20
Figure 5
Figure 5
Adenocarcinoma x20
Figure 6
Figure 6
Small cell lung cancer x20
See this image and copyright information in PMC

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