Improved diagnostic yield of transbronchial lung biopsy in peripheral pulmonary lesions using a combination of endobronchial ultrasound and rapid on-site evaluation

Abstract

Objectives To evaluate the value of rapid on-site evaluation (ROSE) during radial probe endobronchial ultrasound transbronchial lung biopsy (rpEBUS-TBLB) for peripheral pulmonary lesions (PPLs). Methods One hundred and six patients with PPLs who received rpEBUS-TBLB were enrolled in this study. One specimen was immediately examined by ROSE and the other was sent to the central laboratory for cytologic diagnosis. The results of ROSE were compared with those of pathological diagnosis. Results The diagnostic accuracy, sensitivity, and specificity of ROSE during rpEBUS-TBLB for PPLs were 82.1%, 89.6%, and 77.1%, respectively. The procedure times and number of biopsies were less for procedures when ROSE was positive compared with those when ROSE was negative (procedure time: 20.5 ± 7.9 vs. 28.3 ± 7.6 minutes; number of biopsies: 1.6 ± 0.9 vs. 2.8 ± 0.6 times). No serious procedural complications were observed. Conclusions ROSE has value for diagnosing PPLs during rpEBUS. It can reduce procedure time, number of biopsies, and complications. ROSE combined with rpEBUS is an effective and safe method for the diagnosis of PPLs.

Value of rapid on‐site evaluation combined with interventional pulmonology techniques in the diagnosis of pulmonary cryptococcosis

“…ROSE can guide the bronchoscopy process in real time, initially determine the adequacy and qualification rate of specimens and guide further auxiliary examinations, including microbial culture and antigen detection, which helps increase the positive diagnostic rate of infectious diseases. 23 , 24 In this study, EBUS‐TBLB combined with ROSE significantly improved the diagnostic positivity rate and on this basis, when combined with CrAg, achieved the same diagnostic results as CT‐PNB. ROSE can evaluate the quality of the sample during bronchoscopy, distinguish the cytological manifestations of cryptococcal infection and the structural characteristics of the pathogen in the specimen in time and help guide the doctor to send the lavage fluid or blood sample for CrAg testing to improve the diagnosis rate of cryptococcal disease.…”

“…Compared with CT‐PNB, EBUS‐TBLB acquires a smaller tissue size, is less traumatic and can be performed multiple times. ROSE can guide the bronchoscopy process in real time, initially determine the adequacy and qualification rate of specimens and guide further auxiliary examinations, including microbial culture and antigen detection, which helps increase the positive diagnostic rate of infectious diseases 23,24 . In this study, EBUS‐TBLB combined with ROSE significantly improved the diagnostic positivity rate and on this basis, when combined with CrAg, achieved the same diagnostic results as CT‐PNB.…”

The Value of Computed Tomography-Guided Percutaneous Lung Biopsy Combined With Rapid On-Site Evaluation in Diagnosis of Peripheral Pulmonary Nodules

“…With the development of imaging technology, peripheral pulmonary lesions (PPLs) are becoming more and more common in clinical. 1 Early detection and corresponding intervention can effectively reduce the incidence of lung cancer and improve the prognosis. By systematically analyzing the clinical manifestations and chest imaging characteristics, it is often difficult to judge the benign and malignant of PPLs, which is not conducive to follow-up treatment.…”

Machine-Learning-Based Classification Model to Address Diagnostic Challenges in Transbronchial Lung Biopsy

“…In certain scenarios, the target site may be inaccessible, rendering the sampling of the lesion infeasible. Additional diagnostic measures, such as rapid on-site evaluation (ROSE) or bronchoalveolar lavage (BAL), may be employed as supplementary tests [10]. However, even with the integration of these adjunctive measures, a definitive diagnosis is often not achieved.…”