Diagnostic Outcomes and Safety of Cryobiopsy Added to Conventional Sampling Methods

Nakai, Toshiko; Tanaka, Midori; Imabayashi, Tatsuya; Tsuchida, Takaaki; Ohe, Yuichiro

doi:10.1016/j.chest.2021.05.015

Cited by 45 publications

(82 citation statements)

References 41 publications

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“…Although there was heterogeneity in the grading of bleeding severity and the method used to control bleeding, cryobiopsy reportedly induced more bleeding than did forceps biopsy; mild to moderate bleeding occurred in 47-72% of PPLs, whereas the rate of severe bleeding was 0.5%. [18][19][20][21][22][23] Similarly, the most frequently observed complication in this study was mild to moderate bleeding.…”

Section: Discussionmentioning

confidence: 68%

“…Similar results were reported for conventional cryoprobes. 20,23 These suggested that cryobiopsy could be useful even when the R-EBUS probe was adjacent to the lesions. This was attributed to the fact that the cryoprobe allowed biopsy sampling from lateral areas because the tissue surrounding the tip of the probe was frozen.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the diagnostic accuracy has not been acceptable as the accurate insertion of the cryoprobe to some angulated bronchi, such as the upper lobar bronchus, requires advanced techniques. 21,23 Moreover, their reusable design may lead to an inevitable decrease in cooling performance due to mechanical stress and reprocessing through repeated use. 24 uncontrollable mental disorders or dementia, or the presence of any factor that precluded inclusion in the study as determined by the investigators.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16][17] However, cryoprobes have not yet been commonly used to diagnose PPLs, mainly because of the di culties in handling them. [18][19][20][21][22][23] The major limitations of the current cryoprobes with diameters of 1.9 or 2.4 mm in approaching PPLs are their thickness and stiffness. Thus, the diagnostic accuracy has not been acceptable as the accurate insertion of the cryoprobe to some angulated bronchi, such as the upper lobar bronchus, requires advanced techniques.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Diagnostic Value of a New Cryoprobe for Peripheral Pulmonary Lesions: A Prospective Study

Tanaka¹,

Imabayashi²,

Kawahara

et al. 2021

Preprint

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Background: Cryobiopsy is an established technique that yields larger and higher-quality samples than does a forceps biopsy. However, it remains underutilised in the diagnosis of peripheral pulmonary lesions (PPLs), mainly because of difficulties in handling conventional cryoprobes. A recently introduced single-use cryoprobe with a smaller diameter and more flexibility than conventional ones may improve its diagnostic ability for PPLs. We conducted this prospective study to evaluate the feasibility of transbronchial cryobiopsy in the diagnoses of PPLs, using a new 1.7-mm cryoprobe. Methods: The study included patients with PPLs less than 30 mm in diameter scheduled to undergo bronchoscopy. All the procedures were performed using a combination of virtual bronchoscopic navigation, radial endobronchial ultrasound (R-EBUS) and X-ray fluoroscopy, and all the samples were collected using the cryoprobe alone. Thereafter, we assessed the diagnostic outcomes and safety profiles.Results: A total of 50 patients were enrolled and underwent cryobiopsy. The median lesion size was 20.8 mm (range, 8.2–29.6 mm), and the negative bronchus sign was seen in 34% of lesions. The diagnostic yield was 94% (95% confidence interval, 83.5–98.8%). A positive bronchus sign had a significantly higher diagnostic yield than did a negative bronchus sign (100% vs. 82.4%; P=0.035). The yield was achieved regardless of other variables, including lesion size, location, and R-EBUS findings. The major complications were mild and moderate bleeding in 28% and 62% of patients, respectively. Pneumothorax was identified in one patient.Conclusion: Transbronchial cryobiopsy using the new 1.7-mm cryoprobe is a feasible procedure that has the potential to increase the diagnostic accuracy for PPLs.Trial Registration: Japan Registry of Clinical Trials, jRCT1032200065. Registered 8 July 8 2020, https://jrct.niph.go.jp/en-latest-detail/jRCT1032200065

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic Value of a New Cryoprobe for Peripheral Pulmonary Lesions: A Prospective Study

Tanaka¹,

Imabayashi²,

Kawahara

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Stiff instruments restrict the flexion range of the bronchoscope and may result in diagnostic failure; thus, increasingly flexible instruments have been developed (14,22). In addition, instruments have been developed to enable the acquisition of larger samples (e.g., cryoprobes) (22,23); these instruments may enhance the diagnostic yield of bronchoscopy. Multimodal bronchoscopy using combinations of some of these improved modalities has improved diagnostic accuracy for small peripheral pulmonary lesions (17).…”

mentioning

confidence: 99%

Augmented fluoroscopy and cone beam CT-guided needle biopsy using a steerable guiding sheath: a promising approach for peripheral pulmonary lesions

Oki¹,

Sasaki²

2021

Transl Lung Cancer Res

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Air embolism after transbronchial lung cryobiopsy: A case report

Kawataki

Nakanishi

Niwa

et al. 2022

Respirology Case Reports

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A 76‐year‐old woman underwent transbronchial lung cryobiopsy (TBLC) and transbronchial lung biopsy (TBLB) for examination of interstitial infiltrates. After the examination, the patient's consciousness became clouded, and head computed tomography showed an air embolus. She was started on 100% oxygen, and her consciousness improved, but she remained hemiplegic on the left side and dysphagic. Vascular air embolism (VAE) is a rare but serious complication. Although cases of VAE have been reported with conventional transbronchial forceps biopsy, cases of VAE after TBLC are quite rare, and thus this case is reported.

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Diagnostic Outcomes and Safety of Cryobiopsy Added to Conventional Sampling Methods

Cited by 45 publications

References 41 publications

Diagnostic Value of a New Cryoprobe for Peripheral Pulmonary Lesions: A Prospective Study

Diagnostic Value of a New Cryoprobe for Peripheral Pulmonary Lesions: A Prospective Study

Augmented fluoroscopy and cone beam CT-guided needle biopsy using a steerable guiding sheath: a promising approach for peripheral pulmonary lesions

Air embolism after transbronchial lung cryobiopsy: A case report

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