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. 2023 Apr;55(2):506-512.
doi: 10.4143/crt.2022.1008. Epub 2022 Nov 1.

The Additive Impact of Transbronchial Cryobiopsy Using a 1.1-mm Diameter Cryoprobe on Conventional Biopsy for Peripheral Lung Nodules

Soo Han Kim  1   2 , Jeongha Mok  1   2 , Eun-Jung Jo  1 , Mi-Hyun Kim  1 , Kwangha Lee  1 , Ki Uk Kim  1 , Hye-Kyung Park  1 , Min Ki Lee  1 , Jung Seop Eom  1   2
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The Additive Impact of Transbronchial Cryobiopsy Using a 1.1-mm Diameter Cryoprobe on Conventional Biopsy for Peripheral Lung Nodules

Soo Han Kim et al. Cancer Res Treat. 2023 Apr.

Abstract

Purpose: The diagnostic yield of transbronchial biopsy (TBB) using radial probe endobronchial ultrasound (RP-EBUS) is 71%, which is lower than that of transthoracic needle biopsy. We investigated the performance and safety of sequential transbronchial cryobiopsy (TBC) using a novel 1.1-mm diameter cryoprobe, after conventional TBB using RP-EBUS for the diagnosis of peripheral lung lesions (PLLs).

Materials and methods: From April 2021 to November 2021, 110 patients who underwent bronchoscopy using RP-EBUS for the diagnosis of PLL ≤ 30 mm were retrospectively included in our study. All records were followed until June 2022.

Results: The overall diagnostic yield of combined TBB and TBC was 79.1%, which was higher than 60.9% of TBB alone (p=0.005). The diagnostic yield of sequential TBC was 65.5%, which increased the overall diagnostic yield by 18.2%. The surface area of tissues by TBC (mean area, 18.5 mm2) was significantly larger than those of TBB by 1.5-mm forceps (3.4 mm2, p < 0.001) and 1.9-mm forceps (3.7 mm2, p=0.011). In the multivariate analysis, PLLs with the longest diameter of ≤ 22 mm were found to be related to additional diagnostic benefits from sequential TBC (odds ratio, 3.51; 95% confidence interval, 1.043 to 11.775; p=0.042). Complications were found in 10.5% of the patients: pneumothorax (1.0%), infection (1.0%), and significant bleeding (8.6%). None of the patients developed any life-threatening complications.

Conclusion: Sequential TBC with a 1.1-mm cryoprobe improved the performance of conventional TBB using RP-EBUS without serious complications.

Keywords: Bronchoscopy; Diagnosis; Lung neoplasms; Ultrasonography.

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Conflict of interest statement

Conflicts of Interest

Conflict of interest relevant to this article was not reported.

Figures

Fig. 1
Fig. 1
Flow diagram of the study patients. EBUS, endobronchial ultrasound; PLL, peripheral lung lesion; TBB, transbronchial biopsy.
Fig. 2
Fig. 2
Venn diagram of results of the bronchoscopy procedure.
Fig. 3
Fig. 3
Comparisons of the mean longest diameter (A) and the surface area (B) of tissue between cyobiopsy samples and forceps biopsy samples.
See this image and copyright information in PMC

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