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. 2023 Aug 21;49(4):e20230097.
doi: 10.36416/1806-3756/e20230097. eCollection 2023.

Predictive factors for improved diagnostic accuracy with the use of radial-probe EBUS

[Article in English, Portuguese]
Andreia Barroso  1 , Flávia Lin  2 , Maria Cristina Carrondo  3 , Addy Palomino  2 , Sergio Eduardo Demarzo  2 , Viviane Rossi Figueiredo  2 , Marcia Jacomelli  2
Affiliations

Predictive factors for improved diagnostic accuracy with the use of radial-probe EBUS

[Article in English, Portuguese]
Andreia Barroso et al. J Bras Pneumol. .

Abstract
in English, Portuguese

Objective: To assess predictive factors for improved diagnostic accuracy with the use of radial-probe EBUS (RP-EBUS).

Methods: This was a retrospective review of consecutive patients undergoing RP-EBUS between February of 2012 and January of 2020. Parameters including the presence of a bronchus sign on CT scans, the position of the radial EBUS probe, lesion size, lesion location, and lesion type were analyzed in relation to two defined outcomes (final diagnosis or no diagnosis). Univariate analysis was used in order to explore the individual effects of each parameter on diagnostic accuracy. Multivariate logistic regression was performed to identify significant predictors of diagnostic accuracy.

Results: RP-EBUS was used for diagnostic purposes in 101 patients. The lesion was < 3 cm in size in 59 patients (58.4%) and predominantly solid in 60.3%. There was a positive correlation between radial EBUS probe position and diagnostic accuracy (p = 0.036), with 80.9% of the patients showing a bronchus sign on CT scans. Furthermore, 89% of the patients showed a bronchus sign on CT scans and a correlation with diagnostic accuracy (p = 0.030), with 65.8% of the lesions being located in the left/right upper lobe (p = 0.046). When the radial EBUS probe was within the target lesion, the diagnostic yield was = 80.8%. When the probe was adjacent to the lesion, the diagnostic yield was = 19.2%. A bronchus sign on CT scans was the only parameter that independently influenced diagnostic accuracy (adjusted OR, 3.20; 95% CI, 1.081-9.770; p = 0.036).

Conclusions: A bronchus sign on CT scans is a powerful predictor of successful diagnosis by RP-EBUS.

Objetivo:: Avaliar fatores preditivos de maior precisão diagnóstica com EBUS com sonda radial.

Métodos:: Revisão retrospectiva de pacientes consecutivos submetidos a EBUS radial entre fevereiro de 2012 e janeiro de 2020. Parâmetros como a presença do sinal brônquico na TC, a posição da sonda radial de EBUS, o tamanho da lesão, a localização da lesão e o tipo de lesão foram analisados em relação a dois desfechos definidos (diagnóstico final ou sem diagnóstico). A análise univariada foi usada para explorar os efeitos individuais de cada parâmetro na precisão do diagnóstico. A regressão logística multivariada foi realizada para identificar preditores significativos de precisão diagnóstica.

Resultados:: O EBUS radial foi usado para fins diagnósticos em 101 pacientes. A lesão era < 3 cm em 59 pacientes (58,4%) e predominantemente sólida em 60,3%. Houve correlação positiva entre a posição da sonda radial de EBUS e a precisão do diagnóstico (p = 0,036), sendo que 80,9% dos pacientes apresentaram o sinal brônquico na TC. Além disso, 89% dos pacientes apresentaram o sinal brônquico na TC e correlação com a precisão do diagnóstico (p = 0,030), sendo que 65,8% das lesões localizavam-se no lobo superior esquerdo/direito (p = 0,046). Com a sonda radial de EBUS dentro da lesão-alvo, o rendimento diagnóstico foi de 80,8%. Com a sonda adjacente à lesão, o rendimento diagnóstico foi de 19,2%. O sinal brônquico na TC foi o único parâmetro que influenciou de forma independente a precisão do diagnóstico (OR ajustada = 3,20; IC95%: 1,081-9,770; p = 0,036).

Conclusões:: O sinal brônquico na TC é um poderoso preditor de diagnóstico bem-sucedido por meio de EBUS radial.

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Conflict of interest statement

CONFLICTS OF INTEREST: None declared.

Figures

Figure 1
Figure 1. Diagnostic accuracy of radial-probe EBUS, on the basis of clinical characteristics. In the multivariate analysis, the presence of a bronchus sign on CT scans remained as the only independent predictor of diagnostic accuracy (adjusted OR, 3.20; 95% CI, 1.081-9.770; p = 0.036).
Figure 2
Figure 2. ROC curve for factors affecting the accuracy of diagnosis.
Figure 3
Figure 3. Comparison between CT (n A) and radial-probe EBUS with the probe positioned within the lesion (in B).
See this image and copyright information in PMC

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