Diagnostic value of endobronchial ultrasound combined with rapid on‐site evaluation of transbronchial lung biopsy for peripheral pulmonary lesions

Abstract

Abstrac Background Rapid on‐site evaluation (ROSE) has the potential to increase endobronchial ultrasound (EBUS) guide transbronchial lung biopsy (TBLB) accuracy in the diagnosis of peripheral pulmonary lesions (PPLs). However, studies have reported controversial results. The aim of the study was to evaluate the diagnostic value of EBUS‐TBLB combination with ROSE in PPLs. Methods A total of 152 patients with PPLs underwent EBUS were enrolled and completed this study. Patients were divided into EBUS combined with ROSE group (EBUS+ROSE group) and EBUS group (EBUS group). The diagnostic yield, operation time, and complications were compared between the two groups. Results The diagnostic yield in EBUS+ROSE group was 85.9%, the operation time was (24.6 ± 6.8) min, the diagnostic yield in EBUS group was 70.3%, and the operative time was (32.4 ± 8.7) min, there were significant differences in diagnostic yield (χ2 = 5.456, P = .016) and operation time (t = 3.167, P = .001) between the two groups. No severe procedure related complications were observed, such as, pneumothorax and hemorrhage. Conclusions ROSE can improve the diagnostic yield and shorten the operation time. EBUS combined with ROSE is an effective diagnostic method for PPLs.

Impact of rapid on-site evaluation combined with endobronchial ultrasound and virtual bronchoscopic navigation in diagnosing peripheral lung lesions

“…Our study has confirmed the performance of ROSE that it is likely to improve diagnostic yield especially for size of lesion < 2 cm. In disagreement with previous data suggesting reduced operation time in ROSE group [ 12 ], we reported that ROSE could shorten the diagnosis time, and improve cost-effectiveness for R-EBUS patients. On the basis of ROSE findings consistent with subsequent final pathologic diagnosis, it supports our approach of termination of procedure in the event of ROSE revealing malignancy and inflammation without further sampling.…”

“…To the best of our knowledge, limited data are available concerning the application of ROSE during R-EBUS TBB in the diagnosis of PPLs [ 12 – 14 , 18 ]. A prospective RCT enrolling 152 patients with PPLs suggested that ROSE could improve the diagnostic yield and shorten the operation time.…”

“…A prospective RCT enrolling 152 patients with PPLs suggested that ROSE could improve the diagnostic yield and shorten the operation time. Meanwhile, no severe procedure related complications were observed, such as pneumothorax and hemorrhage [ 12 ]. The study was clearly in favor of our results, however, we should note that the researchers did not utilize brushing in the R-EBUS procedure, and the difference in the incidence of hemorrhage between both groups was signicant.…”

“…However, little was known about whether the utility of ROSE can affect the diagnostic yield of EBUS TBB in PPLs [ 12 – 14 ]. Subject to the relatively small size of sample [ 12 ] and the cohort design [ 13 , 14 ], so the inference should be interpreted with caution.…”

“…However, little was known about whether the utility of ROSE can affect the diagnostic yield of EBUS TBB in PPLs [ 12 – 14 ]. Subject to the relatively small size of sample [ 12 ] and the cohort design [ 13 , 14 ], so the inference should be interpreted with caution. Additionally, the current data regarding whether several factors such as location and size of lesion [ 15 , 16 ], inadequate specimen collection affecting the diagnostic yields of EBUS TBB in PPLs [ 17 ] remain confirmed.…”