Predictive value of the resistance of the probe to pass through the lesion in the diagnosis of peripheral pulmonary lesions using radial probe endobronchial ultrasound with a guide sheath
BackgroundTransbronchial lung biopsy guided by radial probe endobronchial ultrasonography with a guide sheath (EBUS-GS-TBLB) is becoming a significant approach for diagnosing peripheral pulmonary lesions (PPLs). We aimed to explore the clinical value of the resistance of the probe to pass through th...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1168870/full |
| _version_ | 1811153950861164544 |
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| author | Zhenli Hu Sen Tian Sen Tian Xiangqi Wang Qin Wang Li Gao Yuxuan Shi Xiang Li Xiang Li Yilian Tang Wei Zhang Yuchao Dong Chong Bai Haidong Huang |
| author_facet | Zhenli Hu Sen Tian Sen Tian Xiangqi Wang Qin Wang Li Gao Yuxuan Shi Xiang Li Xiang Li Yilian Tang Wei Zhang Yuchao Dong Chong Bai Haidong Huang |
| author_sort | Zhenli Hu |
| collection | DOAJ |
| description | BackgroundTransbronchial lung biopsy guided by radial probe endobronchial ultrasonography with a guide sheath (EBUS-GS-TBLB) is becoming a significant approach for diagnosing peripheral pulmonary lesions (PPLs). We aimed to explore the clinical value of the resistance of the probe to pass through the lesion in the diagnosis of PPLs when performing EBUS-GS-TBLB, and to determine the optimum number of EBUS-GS-TBLB.MethodsWe performed a prospective, single-center study of 126 consecutive patients who underwent EBUS-GS-TBLB for solid and positive-bronchus-sign PPLs where the probe was located within the lesion from September 2019 to May 2022. The classification of probe resistance for each lesion was carried out by two bronchoscopists independently, and the final result depended on the bronchoscopist responsible for the procedures. The primary endpoint was the diagnostic yield according with the resistance pattern. The secondary endpoints were the optimum number of EBUS-GS-TBLB and factors affecting diagnostic yield. Procedural complications were also recorded.ResultsThe total diagnostic yield of EBUS-GS-TBLB was 77.8%, including 83.8% malignant and 67.4% benign diseases (P=0.033). Probe resistance type II displayed the highest diagnostic yield (87.5%), followed by type III (81.0%) and type I (61.1%). A significant difference between the diagnostic yield of malignant and benign diseases was detected in type II (P = 0.008), whereas others did not. Although most of the malignant PPLs with a definitive diagnosis using EBUS-GS-TBLB in type II or type III could be diagnosed in the first biopsy, the fourth biopsy contributed the most sufficient biopsy samples. In contrast, considerably limited tissue specimens could be obtained for each biopsy in type I. The inter-observer agreement of the two blinded bronchoscopists for the classification of probe resistance was excellent (κ = 0.84).ConclusionThe probe resistance is a useful predictive factor for successful EBUS-GS-TBLB diagnosis of solid and positive-bronchus-sign PPLs where the probe was located within the lesion. Four serial biopsies are appropriate for both probe resistance type II and type III, and additional diagnostic procedures are needed for type I. |
| first_indexed | 2024-03-12T20:53:48Z |
| format | Article |
| id | doaj.art-37ec014d3dbd468b9979c89c533acb2e |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-12T20:53:48Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-37ec014d3dbd468b9979c89c533acb2e2023-07-31T22:09:22ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-07-011310.3389/fonc.2023.11688701168870Predictive value of the resistance of the probe to pass through the lesion in the diagnosis of peripheral pulmonary lesions using radial probe endobronchial ultrasound with a guide sheathZhenli Hu0Sen Tian1Sen Tian2Xiangqi Wang3Qin Wang4Li Gao5Yuxuan Shi6Xiang Li7Xiang Li8Yilian Tang9Wei Zhang10Yuchao Dong11Chong Bai12Haidong Huang13Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Respiratory and Critical Care Medicine, No. 906 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Ningbo, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Pathology, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Nephrology, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Respiratory and Critical Care Medicine, General Hospital of Central Theater Command of Chinese People’s Liberation Army, Wuhan, ChinaBasic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, ChinaBackgroundTransbronchial lung biopsy guided by radial probe endobronchial ultrasonography with a guide sheath (EBUS-GS-TBLB) is becoming a significant approach for diagnosing peripheral pulmonary lesions (PPLs). We aimed to explore the clinical value of the resistance of the probe to pass through the lesion in the diagnosis of PPLs when performing EBUS-GS-TBLB, and to determine the optimum number of EBUS-GS-TBLB.MethodsWe performed a prospective, single-center study of 126 consecutive patients who underwent EBUS-GS-TBLB for solid and positive-bronchus-sign PPLs where the probe was located within the lesion from September 2019 to May 2022. The classification of probe resistance for each lesion was carried out by two bronchoscopists independently, and the final result depended on the bronchoscopist responsible for the procedures. The primary endpoint was the diagnostic yield according with the resistance pattern. The secondary endpoints were the optimum number of EBUS-GS-TBLB and factors affecting diagnostic yield. Procedural complications were also recorded.ResultsThe total diagnostic yield of EBUS-GS-TBLB was 77.8%, including 83.8% malignant and 67.4% benign diseases (P=0.033). Probe resistance type II displayed the highest diagnostic yield (87.5%), followed by type III (81.0%) and type I (61.1%). A significant difference between the diagnostic yield of malignant and benign diseases was detected in type II (P = 0.008), whereas others did not. Although most of the malignant PPLs with a definitive diagnosis using EBUS-GS-TBLB in type II or type III could be diagnosed in the first biopsy, the fourth biopsy contributed the most sufficient biopsy samples. In contrast, considerably limited tissue specimens could be obtained for each biopsy in type I. The inter-observer agreement of the two blinded bronchoscopists for the classification of probe resistance was excellent (κ = 0.84).ConclusionThe probe resistance is a useful predictive factor for successful EBUS-GS-TBLB diagnosis of solid and positive-bronchus-sign PPLs where the probe was located within the lesion. Four serial biopsies are appropriate for both probe resistance type II and type III, and additional diagnostic procedures are needed for type I.https://www.frontiersin.org/articles/10.3389/fonc.2023.1168870/fullendobronchial ultrasoundtransbronchial lung biopsyperipheral pulmonary lesionsprobe resistancediagnosis |
| spellingShingle | Zhenli Hu Sen Tian Sen Tian Xiangqi Wang Qin Wang Li Gao Yuxuan Shi Xiang Li Xiang Li Yilian Tang Wei Zhang Yuchao Dong Chong Bai Haidong Huang Predictive value of the resistance of the probe to pass through the lesion in the diagnosis of peripheral pulmonary lesions using radial probe endobronchial ultrasound with a guide sheath Frontiers in Oncology endobronchial ultrasound transbronchial lung biopsy peripheral pulmonary lesions probe resistance diagnosis |
| title | Predictive value of the resistance of the probe to pass through the lesion in the diagnosis of peripheral pulmonary lesions using radial probe endobronchial ultrasound with a guide sheath |
| title_full | Predictive value of the resistance of the probe to pass through the lesion in the diagnosis of peripheral pulmonary lesions using radial probe endobronchial ultrasound with a guide sheath |
| title_fullStr | Predictive value of the resistance of the probe to pass through the lesion in the diagnosis of peripheral pulmonary lesions using radial probe endobronchial ultrasound with a guide sheath |
| title_full_unstemmed | Predictive value of the resistance of the probe to pass through the lesion in the diagnosis of peripheral pulmonary lesions using radial probe endobronchial ultrasound with a guide sheath |
| title_short | Predictive value of the resistance of the probe to pass through the lesion in the diagnosis of peripheral pulmonary lesions using radial probe endobronchial ultrasound with a guide sheath |
| title_sort | predictive value of the resistance of the probe to pass through the lesion in the diagnosis of peripheral pulmonary lesions using radial probe endobronchial ultrasound with a guide sheath |
| topic | endobronchial ultrasound transbronchial lung biopsy peripheral pulmonary lesions probe resistance diagnosis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1168870/full |
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