Cryobiopsy in the Diagnosis of Diffuse Interstitial Lung Disease: Yield and Cost-Effectiveness Analysis

Hernández-González, Fernanda; Lucena, Carmen M.; Ramírez, José; Sánchez, Marcelo; Jiménez, Mariano; Xaubet, Antoni; Sellarés, Jacobo; Agustı́, Carlos

doi:10.1016/j.arbr.2015.02.001

Cited by 85 publications

(70 citation statements)

References 33 publications

(36 reference statements)

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“…42,49 Nine studies explicitly defined a diagnostic reference standard (Table 5), which included: (1) interdisciplinary discussion between clinician, radiologist, and pathologist (5 studies); (2) clinical, radiographic, and pathological findings with 6-month follow-up (one study); and (3) clinical, radiographic, and pathological findings (3 studies). 27,38,40,[43][44][45][47][48][49] A variety of diffuse parenchymal lung diseases, including IPF and nonspecific interstitial pneumonia, could be diagnosed with the help of cryo-transbronchial lung biopsy (Table 5).…”

Section: Resultsmentioning

confidence: 99%

“…1). 27,[37][38][39][40][41][42][43][44][45][46][47][48][49] Nine studies were retrospective, 27 39,41 one in immunocompromised subjects with pulmonary infiltrates, 38 and one including subjects from all 3 categories 46 (Table 1). The studies were generally of good quality (Table 2), with the median (interquartile range) QualSyst score being 18 (17)(18)(19).…”

Section: Resultsmentioning

confidence: 99%

Section: Diagnostic Yield Of Cryo-transbronchial Lung Biopsymentioning

confidence: 99%

“…27,[37][38][39][40][42][43][44][45][47][48][49] Five studies further classified the diagnoses achieved with the help of cryo-transbronchial lung biopsy as definite (or confident) or probable. 42,43,[47][48][49] The diagnoses achieved in the remaining 7 studies were considered definite. 27,[37][38][39][40]44,45 The pooled diagnostic yield was 76.9% (95% CI 67.2-85.3) if only the definite diagnoses were considered, whereas it was 85.9% (95% CI 78.2-92.2) when both definite and probable diagnoses were considered (Fig.…”

Section: Diagnostic Yield Of Cryo-transbronchial Lung Biopsymentioning

confidence: 99%

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Diagnostic Yield and Safety of Cryoprobe Transbronchial Lung Biopsy in Diffuse Parenchymal Lung Diseases: Systematic Review and Meta-Analysis

et al. 2016

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BACKGROUND: Transbronchial lung biopsy with flexible forceps is the most commonly used technique in diagnosis of diseases diffusely involving the lung parenchyma. Recently, transbronchial lung biopsy using the flexible cryoprobe (cryo-transbronchial lung biopsy) has also been reported. Herein, we perform a systematic review and meta-analysis describing the efficacy and safety of cryo-transbronchial lung biopsy. METHODS: The PubMed and EMBASE databases were searched for studies reporting the outcomes of cryo-transbronchial lung biopsy in subjects with diffuse parenchymal lung involvement. The quality of individual studies was assessed using the QualSyst tool. The pooled diagnostic yield of cryo-transbronchial lung biopsy was calculated using proportion meta-analysis (random effects model). Heterogeneity was evaluated using the I 2 test and Cochran Q test. Publication bias was determined using both statistical and graphical methods.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Diagnostic Yield Of Cryo-transbronchial Lung Biopsymentioning

confidence: 99%

Section: Diagnostic Yield Of Cryo-transbronchial Lung Biopsymentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic Yield and Safety of Cryoprobe Transbronchial Lung Biopsy in Diffuse Parenchymal Lung Diseases: Systematic Review and Meta-Analysis

et al. 2016

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“…The diagnostic yield and complication rates of TBLC for ILD have been reported in 10 publications from 8 distinct cohorts, [64][65][66][67][68][69][70][71][72][73][74] although there was significant heterogeneity among studies (eg, patient population, method of sedation, flexible vs. rigid bronchoscope, method of determining the diagnosis). The reported diagnostic yield ranges from 51%-98% when TBLC is guided by HRCT and real-time fluoroscopy, varying by whether the diagnostic yield is reported based on pathological findings assessed in isolation or whether biopsies were reviewed in a MDD.…”

Section: Key Messages: Surgical Lung Biopsymentioning

confidence: 99%

Evaluation of patients with fibrotic interstitial lung disease: A Canadian Thoracic Society position statement

Johannson

Kolb

Fell

et al. 2017

Canadian Journal of Respiratory, Critical Care, and Sleep Medic

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Tyrosine Kinase Inhibitor-Induced Interstitial Lung Disease: Clinical Features, Diagnostic Challenges, and Therapeutic Dilemmas

Shah

2016

Drug Saf

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Since the approval of the first molecularly targeted tyrosine kinase inhibitor (TKI), imatinib, in 2001, TKIs have heralded a new era in the treatment of many cancers. Among their innumerable adverse effects, interstitial lung disease (ILD) is one of the most serious, presenting most frequently with dyspnea, cough, fever, and hypoxemia, and often treated with steroids. Of the 28 currently approved TKIs, 16 (57 %) are reported to induce ILD with varying frequency and/or severity. The interval from drug administration to onset of ILD varies between patients and between TKIs, with no predictable time course. Its incidence is variously reported to be approximately 1.6-4.3 % in Japanese populations and 0.3-1.0 % in non-Japanese populations. The mortality rate is in the range of 20-50 %. Available evidence (primarily following the use of erlotinib and gefitinib in Japan because of the unique susceptibility of that population) has identified a number of susceptibility and prognostic risk factors (male sex, a history of smoking, and pre-existing pulmonary fibrosis being the main ones). Although the precise mechanism is not understood, collective evidence suggests that immune factors may be involved. If TKI-induced ILD is confirmed by thorough evaluation of the patient and exclusion of other causes, management is supportive, and includes discontinuation of the culprit TKI and administration of steroids. Discontinuing the culprit TKI presents a clinical dilemma because the diagnosis of TKI-induced ILD in a patient with pre-existing pulmonary fibrosis can be challenging, the patient may have TKI-responsive cancer with no suitable alternative, and switching to an alternative agent, even if available, carries the risk of the patient experiencing other toxic effects. Preliminary evidence suggests that therapy with the culprit TKI may be continued under steroid cover and/or at a reduced dose. However, this approach requires careful individualized risk-benefit analysis and further clinical experience.

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Cryobiopsy in the Diagnosis of Diffuse Interstitial Lung Disease: Yield and Cost-Effectiveness Analysis

Cited by 85 publications

References 33 publications

Diagnostic Yield and Safety of Cryoprobe Transbronchial Lung Biopsy in Diffuse Parenchymal Lung Diseases: Systematic Review and Meta-Analysis

Diagnostic Yield and Safety of Cryoprobe Transbronchial Lung Biopsy in Diffuse Parenchymal Lung Diseases: Systematic Review and Meta-Analysis

Evaluation of patients with fibrotic interstitial lung disease: A Canadian Thoracic Society position statement

Tyrosine Kinase Inhibitor-Induced Interstitial Lung Disease: Clinical Features, Diagnostic Challenges, and Therapeutic Dilemmas

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