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Transbronchial Cryobiopsy Is Superior to Forceps Biopsy for Diagnosing both Fibrotic and Non-Fibrotic Interstitial Lung Diseases.
- Source :
-
Respiration; international review of thoracic diseases [Respiration] 2023; Vol. 102 (9), pp. 852-860. Date of Electronic Publication: 2023 Aug 25. - Publication Year :
- 2023
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Abstract
- Background: Interstitial lung disease (ILD) evaluation often requires lung biopsy for definite diagnosis. In recent years, transbronchial cryobiopsy (TBCB) emerged as a procedure with higher diagnostic yield than transbronchial forceps biopsy (TBFB), especially for fibrotic ILDs. Nonetheless, studies comparing these modalities in non-fibrotic ILDs and for specific ILD diagnoses are scarce.<br />Objectives: The aim of this study was to evaluate the diagnostic yield and safety of TBCB and TBFB in patients with fibrotic and non-fibrotic ILDs.<br />Method: An observational retrospective multicenter study including patients with ILD diagnosis by multidisciplinary discussion that underwent TBCB or TBFB between 2017 and 2021. Chest CT scans were reviewed by a chest radiologist. Biopsy specimens were categorized as diagnostic (with specific histological pattern), nondiagnostic, or without lung parenchyma. Nondiagnostic samples were reassessed by a second lung pathologist. TBCB and TBFB diagnostic yields were analyzed by multivariate regression. Procedural complications were evaluated as well.<br />Results: 276 patients were included, 116 (42%) underwent TBCB and 160 (58%) TBFB. Fibrotic ILDs were present in 148 patients (54%). TBCB diagnostic yield was 78% and TBFB 48% (adjusted odds ratio [AOR] 4.2, 95% CI: 2.4-7.6, p &lt; 0.01). The diagnostic yield of TBCB was higher than TBFB among patients with fibrotic ILD (AOR 3.8, p &lt; 0.01), non-fibrotic ILD (AOR 5.8, p &lt; 0.01), and across most ILD diagnoses. TBCB was associated with higher risk for significant bleeding (10% vs. 3%, p &lt; 0.01), but similar risk for pneumothorax.<br />Conclusions: Diagnostic yield of TBCB was superior to that of TBFB for both fibrotic and non-fibrotic ILDs, and across most diagnoses.<br /> (© 2023 The Author(s). Published by S. Karger AG, Basel.)
Details
- Language :
- English
- ISSN :
- 1423-0356
- Volume :
- 102
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Respiration; international review of thoracic diseases
- Publication Type :
- Academic Journal
- Accession number :
- 37634496
- Full Text :
- https://doi.org/10.1159/000533197