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. 2021 Mar;15(3):320-328.
doi: 10.1111/crj.13301. Epub 2020 Dec 19.

Endobronchial ultrasound guided transbronchial cryobiopsy versus forceps biopsy in peripheral lung lesions

Mohamed Torky  1   2   3 , Wafaa S Elshimy  1 , Mohamed Ae Ragab  1 , Ghada A Attia  1 , Raquel Lopez  4 , Jose Luis Mate  2   4 , Carmen Centeno  3 , Pere Serra  3 , Rachid Tazi Mezalek  3 , Eli Nancy Pérez  5 , Juan Ruiz Manzano  2   3   4 , Antonio Rosell  2   3 , Felipe Andreo  2   3   6
Affiliations

Endobronchial ultrasound guided transbronchial cryobiopsy versus forceps biopsy in peripheral lung lesions

Mohamed Torky et al. Clin Respir J. 2021 Mar.

Abstract

Introduction: Radial probe endobronchial ultrasound (RP-EBUS) is a modern technique for diagnosis of peripheral lung lesions. It is assumed that the addition of transbronchial cryobiopsy (TBCB) could increase the diagnostic value for RP-EBUS.

Objectives: The main objectives were to evaluate the efficacy and safety of RP-EBUS-guided TBCB for diagnosis of peripheral lung lesions and comparing it with RP-EBUS-guided transbronchial forceps biopsy.

Methods: Sixty patients with peripheral lung diseases were divided into two groups. Group I included 45 patients who were eligible for TBCB and they subjected to forceps transbronchial biopsy (forceps TBB) and TBCB guided by RP-EBUS. Fifteen patients who were not eligible for TBCB were included in group II and they were subjected to forceps TBB and/or cytology retrieval procedures guided by RP-EBUS.

Results: In group I, forceps TBB had sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of; 67.5%, 100%, 100%, 18.8%, and 69.8%, respectively, while TBCB had sensitivity, specificity, PPV, NPV, and accuracy of 75%, 100%, 100%, 23.1%, and 76.7%, respectively. The sensitivity in group II was 80% and the overall results including both groups were sensitivity, specificity, PPV, NPV, and accuracy of 85.2%, 100%, 100%, 42.8%, and 86.7%, respectively. Regarding the complications, only one patient (1.7%) had significant bleeding. One patient (1.7%) had pneumothorax and another patient (1.7%) suffered from hypoxemia.

Conclusions: RP-EBUS-guided TBCB is a safe and effective technique for diagnosis of peripheral lung lesions. TBCB has achieved higher diagnostic values and better quality of samples.

Keywords: bronchoscopy; interventional pulmonology; lung cancer; pathology.

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