Bronchoscopic Cryobiopsy and Forceps Biopsy for the Diagnostic Evaluation of Diffuse Parenchymal Lung Disease in Clinical Practice
Objective: To assess the contribution and safety of bronchoscopic cryobiopsy vs traditional forceps biopsy used in clinical practice for diagnosing diffuse parenchymal lung disease (DPLD). Patients and Methods: We identified 271 patients who underwent bronchoscopic biopsy for DPLD at Mayo Clinic, MN...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-10-01
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| Series: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2542454820300977 |
| _version_ | 1818806634478043136 |
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| author | Matthew Koslow, MD Eric S. Edell, MD David E. Midthun, MD John J. Mullon, MD Ryan M. Kern, MD Darlene R. Nelson, MD Kenneth K. Sakata, MD Teng Moua, MD Anja C. Roden, MD Eunhee S. Yi, MD Janani S. Reisenauer, MD Paul A. Decker, MS Jay H. Ryu, MD |
| author_facet | Matthew Koslow, MD Eric S. Edell, MD David E. Midthun, MD John J. Mullon, MD Ryan M. Kern, MD Darlene R. Nelson, MD Kenneth K. Sakata, MD Teng Moua, MD Anja C. Roden, MD Eunhee S. Yi, MD Janani S. Reisenauer, MD Paul A. Decker, MS Jay H. Ryu, MD |
| author_sort | Matthew Koslow, MD |
| collection | DOAJ |
| description | Objective: To assess the contribution and safety of bronchoscopic cryobiopsy vs traditional forceps biopsy used in clinical practice for diagnosing diffuse parenchymal lung disease (DPLD). Patients and Methods: We identified 271 patients who underwent bronchoscopic biopsy for DPLD at Mayo Clinic, MN (June 1, 2013, through September 30, 2017). Medical records were reviewed including prebiopsy clinical and radiographic impressions. Diagnostic yield was assessed in terms of a specific histologic pattern resulting in a diagnosis when combined with the clinical-radiologic context. Clinical utility was defined as a biopsy result deemed useful in patient management. Results: The cohort included 120 cryobiopsy and 151 forceps biopsy cases with mean age 61±14 years and 143 (53%) men. Diagnostic yield (55% vs 41%; odds ratio [OR], 1.73; 95% CI, 1.07 to 2.83; P=.026) and clinical utility (60% vs 40%; OR, 2.21; 95% CI, 1.36 to 3.63; P=.001) were higher for the cryobiopsy group, and the association remained after control for prebiopsy clinical impressions (OR, 2.21; 95% CI, 1.22 to 4.08; P=.010 and OR, 3.23; 95% CI, 1.76 to 6.10; P<.001, respectively). However, pneumothorax (5.4% vs 0.7%; P=.022) and serious bleeding (7.1% vs 0%; P=.001) rates were higher for the cryobiopsy group. Thirty-day mortality was 1.6% in the cryobiopsy group vs 0% for the forceps biopsy group (P=.20). Conclusion: Bronchoscopic cryobiopsy revealed higher diagnostic yield and clinical utility than did forceps biopsy. However, procedure-related complications were higher in the cryobiopsy group. The choice of bronchoscopic biopsy procedure for patients with DPLD depends on the clinicalradiologic context. |
| first_indexed | 2024-12-18T19:12:53Z |
| format | Article |
| id | doaj.art-3e0f7c605650409d9b6a2a887a999993 |
| institution | Directory Open Access Journal |
| issn | 2542-4548 |
| language | English |
| last_indexed | 2024-12-18T19:12:53Z |
| publishDate | 2020-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| spelling | doaj.art-3e0f7c605650409d9b6a2a887a9999932022-12-21T20:56:12ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482020-10-0145565574Bronchoscopic Cryobiopsy and Forceps Biopsy for the Diagnostic Evaluation of Diffuse Parenchymal Lung Disease in Clinical PracticeMatthew Koslow, MD0Eric S. Edell, MD1David E. Midthun, MD2John J. Mullon, MD3Ryan M. Kern, MD4Darlene R. Nelson, MD5Kenneth K. Sakata, MD6Teng Moua, MD7Anja C. Roden, MD8Eunhee S. Yi, MD9Janani S. Reisenauer, MD10Paul A. Decker, MS11Jay H. Ryu, MD12Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Interstitial Lung Disease Program, National Jewish Health, Interstitial Lung Disease and Autoimmune Lung Center, Denver, CO; Correspondence: Address to Matthew Koslow, MD, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO 80206.Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MNDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MNDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MNDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MNDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MNDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MNDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MNDivision of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MNDivision of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MNDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Department of Thoracic Surgery, Mayo Clinic, Rochester, MNDepartment of Health Sciences Research, Mayo Clinic, Rochester, MNDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MNObjective: To assess the contribution and safety of bronchoscopic cryobiopsy vs traditional forceps biopsy used in clinical practice for diagnosing diffuse parenchymal lung disease (DPLD). Patients and Methods: We identified 271 patients who underwent bronchoscopic biopsy for DPLD at Mayo Clinic, MN (June 1, 2013, through September 30, 2017). Medical records were reviewed including prebiopsy clinical and radiographic impressions. Diagnostic yield was assessed in terms of a specific histologic pattern resulting in a diagnosis when combined with the clinical-radiologic context. Clinical utility was defined as a biopsy result deemed useful in patient management. Results: The cohort included 120 cryobiopsy and 151 forceps biopsy cases with mean age 61±14 years and 143 (53%) men. Diagnostic yield (55% vs 41%; odds ratio [OR], 1.73; 95% CI, 1.07 to 2.83; P=.026) and clinical utility (60% vs 40%; OR, 2.21; 95% CI, 1.36 to 3.63; P=.001) were higher for the cryobiopsy group, and the association remained after control for prebiopsy clinical impressions (OR, 2.21; 95% CI, 1.22 to 4.08; P=.010 and OR, 3.23; 95% CI, 1.76 to 6.10; P<.001, respectively). However, pneumothorax (5.4% vs 0.7%; P=.022) and serious bleeding (7.1% vs 0%; P=.001) rates were higher for the cryobiopsy group. Thirty-day mortality was 1.6% in the cryobiopsy group vs 0% for the forceps biopsy group (P=.20). Conclusion: Bronchoscopic cryobiopsy revealed higher diagnostic yield and clinical utility than did forceps biopsy. However, procedure-related complications were higher in the cryobiopsy group. The choice of bronchoscopic biopsy procedure for patients with DPLD depends on the clinicalradiologic context.http://www.sciencedirect.com/science/article/pii/S2542454820300977 |
| spellingShingle | Matthew Koslow, MD Eric S. Edell, MD David E. Midthun, MD John J. Mullon, MD Ryan M. Kern, MD Darlene R. Nelson, MD Kenneth K. Sakata, MD Teng Moua, MD Anja C. Roden, MD Eunhee S. Yi, MD Janani S. Reisenauer, MD Paul A. Decker, MS Jay H. Ryu, MD Bronchoscopic Cryobiopsy and Forceps Biopsy for the Diagnostic Evaluation of Diffuse Parenchymal Lung Disease in Clinical Practice Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| title | Bronchoscopic Cryobiopsy and Forceps Biopsy for the Diagnostic Evaluation of Diffuse Parenchymal Lung Disease in Clinical Practice |
| title_full | Bronchoscopic Cryobiopsy and Forceps Biopsy for the Diagnostic Evaluation of Diffuse Parenchymal Lung Disease in Clinical Practice |
| title_fullStr | Bronchoscopic Cryobiopsy and Forceps Biopsy for the Diagnostic Evaluation of Diffuse Parenchymal Lung Disease in Clinical Practice |
| title_full_unstemmed | Bronchoscopic Cryobiopsy and Forceps Biopsy for the Diagnostic Evaluation of Diffuse Parenchymal Lung Disease in Clinical Practice |
| title_short | Bronchoscopic Cryobiopsy and Forceps Biopsy for the Diagnostic Evaluation of Diffuse Parenchymal Lung Disease in Clinical Practice |
| title_sort | bronchoscopic cryobiopsy and forceps biopsy for the diagnostic evaluation of diffuse parenchymal lung disease in clinical practice |
| url | http://www.sciencedirect.com/science/article/pii/S2542454820300977 |
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