Dataset Information

The effect of 1.9-mm versus 2.4-mm probes in transbronchial cryobiopsies for interstitial lung diseases: a prospective analysis.

ABSTRACT:

Background

Transbronchial cryobiopsy (TBCB) is critical procedure in the diagnosis interstitial lung diseases (ILD). The procedure utilizes cryoprobes of different sizes (1.9-mm or 2.4-mm probes). This study aimed to compare the effect of different cryoprobe types on the outcomes of TBCB.

Methods

This study was analyzed from an updated single-center prospective cohort study between September 2018 and January 2020 (NCT04047667). TBCB was performed in patients with ILD using 1.9-mm or 2.4-mm cryoprobes. The size and quality of specimens, complications, and histopathological and multidisciplinary discussion (MDD) diagnoses were compared between the cryoprobes.

Results

TBCB was performed on 52 and 164 patients with 1.9- and 2.4-mm cryoprobes, respectively. The specimens obtained using the 2.4-mm probe were significantly larger than those obtained with the 1.9-mm probe (surface area: 24.6 vs. 22.0 mm², P<0.001). Both percentages of grossly and microscopically qualified specimens acquired with the 2.4-mm probe were significantly higher than those obtained with the 1.9-mm probe (grossly qualified: 80.1% vs. 66.7%, P<0.001; microscopically qualified: 99.4% vs. 90.4%, P=0.003). No significant differences were found in the incidence of pneumothorax (3.7% vs. 0.0%, P=0.360) or the risk of moderate bleeding (9.1% vs. 11.5%, P=0.612) between the two groups. Additionally, no significant differences were observed in the pathological or MDD diagnostic yields. Multivariate analysis indicated that pathological diagnostic yield in patients with microscopically qualified specimens was significantly higher than that with unqualified specimens.

Conclusions

Specimens obtained using the 2.4-mm probe were of significantly better size and quality than those obtained using the 1.9-mm probe. No significant differences were observed between the two probes with respect to the safety profile and diagnostic yield.

SUBMITTER: Zhou G

PROVIDER: S-EPMC7859758 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

The effect of 1.9-mm versus 2.4-mm probes in transbronchial cryobiopsies for interstitial lung diseases: a prospective analysis.

Zhou Guowu G Ren Yanhong Y Li Jun J Yang Ting T Su Nan N Zhao Ling L Wang Shumeng S Wang Dan D Li Ying Y Tian Zheng Z Liu Ruihong R Dai Huaping H Wang Chen C

Annals of translational medicine 20210101 1

<h4>Background</h4>Transbronchial cryobiopsy (TBCB) is critical procedure in the diagnosis interstitial lung diseases (ILD). The procedure utilizes cryoprobes of different sizes (1.9-mm or 2.4-mm probes). This study aimed to compare the effect of different cryoprobe types on the outcomes of TBCB.<h4>Methods</h4>This study was analyzed from an updated single-center prospective cohort study between September 2018 and January 2020 (NCT04047667). TBCB was performed in patients with ILD using 1.9-mm ...[more]

PMID: 33553313

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Project description:BACKGROUND:Bronchoscopic cryobiopsy is a new method of bronchoscopic tissue sampling in interstitial lung disease. In case of transbronchial biopsies, the resultant tissue samples are of high quality, and the lung parenchyma seen in the samples is adequate for a histological diagnosis in most cases. Bleeding after transbronchial biopsy is the most important procedure- associated complication and may be life threatening. This study addresses the risk of bleeding of transbronchial cryobiopsy. METHODS:In this prospective, randomized, controlled multicentre study 359 patients with interstitial lung disease requiring diagnostic bronchoscopic tissue sampling were included. Both conventional transbronchial forceps biopsy and transbronchial cryobiopsy were undertaken in each patient. The sequence of the procedures was randomized. Bleeding severity was evaluated semi-quantitatively as "no bleeding", "mild" (suction alone), "moderate" (additional intervention) or "severe" (prolonged monitoring necessary or fatal outcome), for each intervention. RESULTS:In 359 patients atotal of 1160 cryobiopsies and 1302 forceps biopsies were performed. Bleeding was observed after forceps biopsy in 173 patients (48.2%) and after cryobiopsy in 261 patients (72.7%). Bleeding was significantly greater in the cryobiopsy group (cryobiopsy/forceps biopsy: no bleeding 27.3%/51.8%; mild 56.5%/44.0%; moderate 15.0%/4.2%; severe 1.2%/0%; p?<?0.001). The rate of clinically relevant bleeding (moderate or severe) was higher after the cryobiopsy procedures compared to the forceps biopsies (16.2% vs. 4.2%, p?<?0.05). No fatal bleeding complications occurred. CONCLUSIONS:Compared to transbronchial forceps biopsy, transbronchial cryobiopsy was associated with an increased risk of bleeding which is of clinical relevance. Therefore training and additional precautions for bleeding control should be considered. TRIAL REGISTRATION:The study was registered with clinicaltrials.gov ( NCT01894113 ).

Project description:BackgroundPulmonary lymphangitic carcinomatosis (PLC) is characterized by malignant infiltration into lung lymphatic channels from a primary site and is often observed in advanced malignant tumors. This study aimed to evaluate the diagnostic yield of transbronchial lung cryobiopsy in PLC guided by radial endobronchial ultrasound and virtual bronchoscopic navigation (VBN).MethodsThis prospective study enrolled 40 patients with clinical and radiologic features indicating PLC. The radial endobronchial ultrasound probe was initially advanced to the region of interest of the desired lobe near the pleura with guidance by VBN. Transbronchial lung biopsy and transbronchial lung cryobiopsy were both performed in the same ROI of all patients with the obtained samples being sent to the pathology laboratory for diagnostic analysis. Procedural complications were recorded.ResultsThe average number of transbronchial lung biopsy and transbronchial lung cryobiopsy specimens were 4 (3 to 6) and 2 (1 to 3), respectively (t=10.43, P<0.01), with the corresponding mean diameters per biopsy being 3.7 and 8.7 mm (t=12.37, P<0.01). The diagnostic yields of transbronchial lung biopsy and transbronchial lung cryobiopsy were 70% (28/40) and 92.5% (37/40), respectively. The final positive predictive values of transbronchial lung cryobiopsy and transbronchial lung biopsy for PLC were 94.4% (34/36) and 77.8% (28/36), respectively (χ2=23.94, P<0.01). Further, 52.2% (12/23) and 81.5% (22/27) of the patients in the transbronchial lung biopsy and transbronchial lung cryobiopsy groups, respectively, were diagnosed with non-small lung cancer after further molecular analysis (χ2=19.56, P<0.01). Only 2 (5%) cases presented postoperative pneumothorax. Moreover, 0 (0%), 3 (7.5%), and 17 (42.5%) patients presented severe, moderate, and mild bleeding, respectively. There were no other adverse events or deaths.ConclusionsTransbronchial lung cryobiopsy with the guidance of radial endobronchial ultrasound and VBN without fluoroscopy has a good diagnostic yield for PLC; moreover, it allows one to obtain adequate and intact tissue samples for further molecular analysis.

Dataset Information

The effect of 1.9-mm versus 2.4-mm probes in transbronchial cryobiopsies for interstitial lung diseases: a prospective analysis.

Background

Methods

Results

Conclusions

Publications

The effect of 1.9-mm versus 2.4-mm probes in transbronchial cryobiopsies for interstitial lung diseases: a prospective analysis.

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