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. 2025 Jul:205:108636.
doi: 10.1016/j.lungcan.2025.108636. Epub 2025 Jun 24.

Application of endobronchial ultrasound-guided cryobiopsy for centrally located intrapulmonary lesions: A retrospective cohort study

Toshiyuki Nakai  1 , Sayaka Tanaka  2 , Hiroaki Nagamine  3 , Atsushi Miyamoto  4 , Misako Nishimura  5 , Yoshiya Matsumoto  6 , Kanako Sato  7 , Kazuhiro Yamada  8 , Tetsuya Watanabe  9 , Kazuhisa Asai  10 , Yuji Matsumoto  11 , Yu Mikami  12 , Tomoya Kawaguchi  13
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Free article

Application of endobronchial ultrasound-guided cryobiopsy for centrally located intrapulmonary lesions: A retrospective cohort study

Toshiyuki Nakai et al. Lung Cancer. 2025 Jul.
Free article

Abstract

Background and objective: Endobronchial ultrasound-guided cryobiopsy (EBUS-cryo) enables the collection of high-quality specimens from lymphadenopathy. Expanding its application to intrapulmonary lesions may provide sufficient tissue quality and quantity for lung tumors. Therefore, we introduced EBUS-cryo through the tract created by EBUS-transbronchial needle aspiration (TBNA) for centrally located intrapulmonary lesions (CLILs) and evaluated its diagnostic utility, safety, and tissue sampling capability for CLILs.

Methods: Consecutive patients who underwent EBUS-cryo following EBUS-TBNA to diagnose CLILs at Osaka Metropolitan University Hospital between March 2023 and December 2024 were retrospectively analyzed. An expert pathologist assessed the quality and area of all tissue specimens, grading quality on a six-point scale (1-6), where scores of ≥ 5 defined as high quality. The tissue specimens' quality, area, and diagnostic performance of each biopsy technique were compared.

Results: Of the 74 cases, 70 successful cases were included in the analysis. The diagnostic yields of EBUS-cryo and EBUS-TBNA were 95.7 % and 91.4 %, respectively (P = 0.51). Moderate bleeding occurred in 5.7 %; however, no severe complications were observed. The mean quality score and specimen area were higher with EBUS-cryo than with EBUS-TBNA (quality: 4.84 ± 1.31 vs. 2.27 ± 1.09, P < 0.001; area: 5.90 ± 3.06 mm2 vs. 4.10 ± 3.51 mm2, P < 0.001). The retrieval rate of high-quality specimens was higher with EBUS-cryo than with EBUS-TBNA (177/243, 72.8 % vs. 10/227, 4.4 %; P < 0.001).

Conclusion: Application of EBUS-cryo to CLILs offers high diagnostic utility, acceptable safety, and superior tissue sampling capability.

Keywords: Bronchoscopy; Centrally located intrapulmonary lesions (CLILs); Cryobiopsy; Endobronchial ultrasound-guided cryobiopsy (EBUS-cryo); Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA); Lung cancer.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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