Utility of Radial Probe Endobronchial Ultrasound Guided Transbronchial Lung Biopsy in Bronchus Sign Negative Peripheral Pulmonary Lesions.

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  • Additional Information
    • Source:
      Publisher: Korean Academy of Medical Science Country of Publication: Korea (South) NLM ID: 8703518 Publication Model: Electronic Cited Medium: Internet ISSN: 1598-6357 (Electronic) Linking ISSN: 10118934 NLM ISO Abbreviation: J Korean Med Sci Subsets: MEDLINE
    • Publication Information:
      Original Publication: Seoul, Korea : Korean Academy of Medical Science, [1986-
    • Subject Terms:
      Biopsy/*methods ; Bronchoscopy/*methods ; Endosonography/*instrumentation ; Endosonography/*methods ; Lung/*pathology ; Lung Neoplasms/*pathology ; Multiple Pulmonary Nodules/*pathology ; Ultrasonography, Interventional/*methods; Adult ; Aged ; Biopsy/instrumentation ; Bronchi/pathology ; Female ; Humans ; Lung Neoplasms/diagnostic imaging ; Male ; Middle Aged ; Multiple Pulmonary Nodules/diagnostic imaging ; Predictive Value of Tests ; Retrospective Studies ; Tomography, X-Ray Computed/methods
    • Abstract:
      Background: The presence of the bronchus sign on chest computed tomography is associated with an increased diagnostic yield of radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB). However, the utility of RP-EBUS-TBLB for bronchus sign negative peripheral pulmonary lesions (PPLs) remains unknown. We investigated the utility of RP-EBUS-TBLB in bronchus sign negative PPLs.
      Methods: We retrospectively reviewed data from 109 patients who underwent RP-EBUS for bronchus sign negative PPLs from January 2019 to August 2020. TBLB was performed using RP-EBUS with a guide sheath and without fluoroscopy. The EBUS visualization and TBLB diagnostic yields were assessed. Multivariable logistic regression analyses were used to identify factors affecting the EBUS visualization and diagnostic yields.
      Results: The EBUS visualization yield was 74.1% (68/109). Of the 109 lung lesions, 92 were definitively diagnosed. The overall diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 50.5% (55/109), 34.9% (29/83), 100% (26/26), 100% (29/29), and 32.5% (26/80), respectively. In multivariable analyses, the size of the lesion (≥ 20 mm; odds ratio [OR], 2.62; 95% confidence interval [CI], 1.16-5.93; P = 0.021) and the distance from the pleura (> 10 mm; OR, 2.37; 95% CI, 1.02-5.52; P = 0.045) were associated with EBUS visualization. Regarding diagnostic yield, having the probe within the lesion (OR, 28.50; 95% CI, 6.26-129.85; P < 0.001) and a solid lesion (OR, 14.58; 95% CI, 2.64-80.38; P = 0.002) were associated with diagnostic success. Pneumothorax and hemoptysis occurred in 3.7% (4/109) and 0.9% (1/109), respectively, of the patients.
      Conclusion: RP-EBUS-TBLB using a GS can be considered a diagnostic method in bronchus sign negative solid PPLs. Having the probe within the lesion and a solid lesion were important for diagnostic success. Complication rates were acceptable.
      Competing Interests: The authors have no potential conflicts of interest to disclose.
      (© 2021 The Korean Academy of Medical Sciences.)
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    • Grant Information:
      2021M3E5D1A02015265 Korea NRF National Research Foundation of Korea; 2021R1C1C1009508 Korea NRF National Research Foundation of Korea
    • Contributed Indexing:
      Keywords: Biopsy; Bronchoscopy; Diagnosis; Ultrasonography
    • Publication Date:
      Date Created: 20210622 Date Completed: 20211102 Latest Revision: 20211102
    • Publication Date:
      20231215
    • Accession Number:
      PMC8216993
    • Accession Number:
      10.3346/jkms.2021.36.e176
    • Accession Number:
      34155838