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

• Published in: Cancer research and treatment Vol. 55; no. 2; pp. 506 - 512
• Main Authors: Kim, Soo Han, Mok, Jeongha, Jo, Eun-Jung, Kim, Mi-Hyun, Lee, Kwangha, Kim, Ki Uk, Park, Hye-Kyung, Lee, Min Ki, Eom, Jung Seop
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Cancer Association 01.04.2023; 대한암학회
• Subjects: Biopsy - adverse effects; Bronchoscopy - adverse effects; Humans; Lung - diagnostic imaging; Lung - pathology; Lung Neoplasms - diagnosis; Lung Neoplasms - pathology; Original; Retrospective Studies; 의학일반; Bronchoscopy; Diagnosis; Ultrasonography; Lung neoplasms
• ISSN: 1598-2998; 2005-9256; 2005-9256
• DOI: 10.4143/crt.2022.1008

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.