The many facets of diagnostic bronchoscopy for pulmonary ground glass nodules

Chavez, Christine; Izumo, Takehiro

doi:10.21037/jtd.2017.03.17

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…However, in type Ic, as represented by ground-glass nodules, the bronchus penetrated into the tumor without mucosal invasion [ 25 ], making it challenging to obtain sufficient samples for diagnosis relative to the other types, despite confirmation of “within” images by rEBUS. Accordingly, for the diagnosis of type Ic lesions, the use of sampling devices that can obtain larger tissue samples beyond the peripheral bronchial wall is recommended [ 8 , 31 ]. However, the 1.9 mm forceps predominantly used in this study did not provide a sufficient diagnostic outcome.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Bronchus Sign Subclassification during Radial Endobronchial Ultrasound-Guided Transbronchial Biopsy: A Retrospective Analysis

Imabayashi¹,

Uchimura²,

Furuse³

et al. 2023

Diagnostics

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The presence of computed tomography bronchus sign (CT-BS) substantially increases the diagnostic yield of peripheral pulmonary lesions. However, the clinical significance of subdividing CT-BS remains controversial. We classified bronchus types on CT into six subtypes (CT-BS group I: types Ia–Ic with the bronchus connected within the lesion, group II: types IIa–IIc without connection) to clarify the differences in their characteristics and investigate the factors associated with diagnosis during radial endobronchial ultrasound (rEBUS)-guided bronchoscopy. In total, 1021 cases were analyzed. Our findings in diagnostic yields were that in CT-BS group I, penetrating type Ic was inferior to obstructed type Ia and narrowing type Ib (59.0% vs. 80.0% and 76.3%, p < 0.001, p = 0.004); in CT-BS group II, compressed type IIa showed no difference when compared with invisible type IIb and uninvolved type IIc (IIa: 52.8% vs. IIb: 46.3% and IIc: 35.7%, p = 0.253). Multivariable analysis revealed that bronchus type (types Ia and Ib vs. Ic) was a significant independent predictor of successful diagnosis in CT-BS group I (odds ratio, 1.78; 95% confidence interval, 1.04–3.05; p = 0.035), along with known factors such as rEBUS visualization. CT-BS subclassification may provide useful information regarding the bronchoscopic technique to facilitate accurate diagnosis.

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Section: Discussionmentioning

confidence: 99%

Computed Tomography Bronchus Sign Subclassification during Radial Endobronchial Ultrasound-Guided Transbronchial Biopsy: A Retrospective Analysis

Imabayashi¹,

Uchimura²,

Furuse³

et al. 2023

Diagnostics

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“…As Dr. Chaves mentioned, tissue sampling from GGO lesions is another problem that complicates diagnosis (3). I agree with their opinion that sampling a large specimen using a large forceps or cryobiopsy might have advantages for diagnosis of GGO lesions.…”

mentioning

confidence: 90%

“…Although peripheral GGO predominant-type lesions are difficult to diagnose by bronchoscopy, even with EBUS technique (3). Especially, in the case of pure GGO, the change in brightness on EBUS images was very delicate when the EBUS probe was in and out of the lesions (4,5).…”

mentioning

confidence: 99%