Lung Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: A Series Contribution to a Debated Procedure

Zhou

et al. 2022

Clinical Respiratory J

Introduction: Transbronchial lung cryobiopsy (TBLC) is a new technique to obtain specimens for diagnosis of interstitial lung disease (ILD) in recent years.The objective of this study is to evaluate the safety and the diagnostic accuracy of TBLC in patients of desquamative interstitial pneumonia (DIP).Methods: In this study twelve patients confirmed with DIP were selected from January 2019 to December 2020 at the department of pulmonary and critical care medicine in China-Japan Friendship Hospital. All cases underwent TBLC in a hybrid cone beam CT (CBCT) operation room with a single general anesthesia. The definitive diagnosis was made by a multidisciplinary team that involved clinicians, radiologists and pathologists. This study analyzed the biopsy sample surface areas, main complications and the consistency between TBLC pathology and multidisciplinary discussion (MDD) diagnosis for DIP. Results: An average of 3.1 AE 1.1 specimens were obtained per patient. The mean surface area of the specimen was 23.7 AE 6.1 mm 2 . None of the cases had pneumothorax or massive hemorrhage. Ten cases (83.3%) had no or mild bleeding and two cases (16.7%) had moderate bleeding. All cases had the typical pathologic characteristics of DIP, which was highly consistent with the diagnosis of MDD. Conclusion: TBLC can obtain sufficient samples for the pathological diagnosis of DIP, which has high security and accuracy in experienced specialist centers.

Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Safety and accuracy of transbronchial lung cryobiopsy in diagnosing desquamative interstitial pneumonia

Zhou

et al. 2022

Clinical Respiratory J

“…Transbronchial lung cryobiopsy (TBLC) can yield significantly larger biopsies than TBLB [5,6] and has been suggested as an acceptable alternative to SLB in achieving a diagnosis of ILD due to its high diagnostic yield, adequate representation of the pattern of lung injury, and an acceptable safety profile. Though reports are variable and largely retrospective in nature, the diagnostic yield of cryobiopsy has been reported between 70 and 80% [7][8][9][10][11][12]. However, 2 recently published randomized trials investigating the concordance of TBLC and SLB, by performing them concurrently on the same patient, have reached different conclusions.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Forceps, Cryoprobe, and Thoracoscopic Lung Biopsy for the Diagnosis of Interstitial Lung Disease − The CHILL Study

Wahidi¹,

Argento²,

Mahmood³

et al. 2021

Respiration

Rationale: Transbronchial lung cryobiopsy (TBLC) has emerged as a less invasive method to obtain a tissue diagnosis in patients with interstitial lung disease (ILD). The diagnostic yield of TBLC compared to surgical lung biopsy (SLB) remains uncertain. Objectives: The aim of this study was to determine the diagnostic accuracy of forceps transbronchial lung biopsy (TBLB) and TBLC compared to SLB when making the final diagnosis based on multidisciplinary discussion (MDD). Methods: Patients enrolled in the study underwent sequential TBLB and TBLC followed immediately by SLB. De-identified cases, with blinding of the biopsy method, were reviewed by a blinded pathologist and then discussed at a multidisciplinary conference. Main Results: Between August 2013 and October 2017, we enrolled 16 patients. The raw agreement between TBLC and SLB for the MDD final diagnosis was 68.75% with a Cohen’s kappa of 0.6 (95% CI 0.39, 0.81). Raw agreement and Cohen’s kappa of TBLB versus TBLC and TBLB versus SLB for the MDD final diagnosis were much lower (50%, 0.21 [95% CI 0, 0.42] and 18.75%, 0.08 [95% CI −0.03, 0.19], respectively). TBLC was associated with mild bleeding (grade 1 bleeding requiring suction to clear) in 56.2% of patients. Conclusions: In patients with ILD who have an uncertain type based on clinical and radiographic data and require tissue sampling to obtain a specific diagnosis, TBLC showed moderate correlation with SLB when making the diagnosis with MDD guidance. TBLB showed poor concordance with both TBLC and SLB MDD diagnoses.

Archives of Pathology &Amp; Laboratory Medicine

“…In a recent retrospective study by Harari et al, 52 the diagnostic performance and safety of cryobiopsy was assessed in a cohort of 73 patients, among which, a specific diagnosis was reached in 64 cases (sensitivity: 88%). Of the remaining 9 cases, 5 (7%) were inadequate and 4 (5%) were found to be nondiagnostic.…”

Section: Diagnostic Yield In Ildmentioning

confidence: 99%

Transbronchial Cryobiopsy in the Diagnosis of Fibrotic Interstitial Lung Disease

Mehrad

Colby

Rossi

et al. 2020

Self Cite

Context.— Transbronchial cryobiopsy is an emerging procedure to obtain lung tissue for diagnosis of interstitial lung disease and has gained popularity because it is less invasive and has a lower rate of complications compared with nonselective surgical lung biopsy. Objective.— To provide an overview of the status of the medical literature regarding transbronchial cryobiopsy . Data Sources.— A literature search was performed using PubMed search engine. The terms “cryobiopsy” or “cryoprobe” and “interstitial lung disease” or “diffuse parenchymal lung disease” or “pulmonary fibrosis” were used, with the search concluding at the end of November 2019. Conclusions.— While the diagnostic yield of transbronchial cryobiopsy is slightly lower than surgical lung biopsy, a growing literature suggests that with a multidisciplinary approach cryobiopsy provides diagnostic and prognostic information approaching that of surgical lung biopsy with lower morbidity and mortality.