Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis.
Advances in bronchoscopy and CT-guided lung biopsy have improved the evaluation of small pulmonary lesions (PLs), leading to an increase in preoperative histological diagnosis. We aimed to evaluate the efficacy and safety of transbronchial lung biopsy using radial endobronchial ultrasound and virtua...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2018-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5777651?pdf=render |
| _version_ | 1811321529502269440 |
|---|---|
| author | Yeji Han Hyun Jung Kim Kyoung Ae Kong Soo Jung Kim Su Hwan Lee Yon Ju Ryu Jin Hwa Lee Yookyoung Kim Sung Shine Shim Jung Hyun Chang |
| author_facet | Yeji Han Hyun Jung Kim Kyoung Ae Kong Soo Jung Kim Su Hwan Lee Yon Ju Ryu Jin Hwa Lee Yookyoung Kim Sung Shine Shim Jung Hyun Chang |
| author_sort | Yeji Han |
| collection | DOAJ |
| description | Advances in bronchoscopy and CT-guided lung biopsy have improved the evaluation of small pulmonary lesions (PLs), leading to an increase in preoperative histological diagnosis. We aimed to evaluate the efficacy and safety of transbronchial lung biopsy using radial endobronchial ultrasound and virtual bronchoscopic navigation (TBLB-rEBUS&VBN) and CT-guided transthoracic needle biopsy (CT-TNB) for tissue diagnosis of small PLs.A systematic search was performed in five electronic databases, including MEDLINE, EMBASE, Cochrane Library Central Register of Controlled Trials, Web of Science, and Scopus, for relevant studies in May 2016; the selected articles were assessed using meta-analysis. The articles were limited to those published after 2000 that studied small PLs ≤ 3 cm in diameter.From 7345 records, 9 articles on the bronchoscopic (BR) approach and 15 articles on the percutaneous (PC) approach were selected. The pooled diagnostic yield was 75% (95% confidence interval [CI], 69-80) using the BR approach and 93% (95% CI, 90-96) using the PC approach. For PLs ≤ 2 cm, the PC approach (pooled diagnostic yield: 92%, 95% CI: 88-95) was superior to the BR approach (66%, 95% CI: 55-76). However, for PLs > 2 cm but ≤ 3 cm, the diagnostic yield using the BR approach was improved to 81% (95% CI, 75-85). Complications of pneumothorax and hemorrhage were rare with the BR approach but common with the PC approach.CT-TNB was superior to TBLB-rEBUS&VBN for the evaluation of small PLs. However, for lesions greater than 2 cm, the BR approach may be considered considering its diagnostic yield of over 80% and the low risk of procedure-related complications. |
| first_indexed | 2024-04-13T13:19:38Z |
| format | Article |
| id | doaj.art-46d4d020cf824c5388407a03409fe40b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T13:19:38Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-46d4d020cf824c5388407a03409fe40b2022-12-22T02:45:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01131e019159010.1371/journal.pone.0191590Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis.Yeji HanHyun Jung KimKyoung Ae KongSoo Jung KimSu Hwan LeeYon Ju RyuJin Hwa LeeYookyoung KimSung Shine ShimJung Hyun ChangAdvances in bronchoscopy and CT-guided lung biopsy have improved the evaluation of small pulmonary lesions (PLs), leading to an increase in preoperative histological diagnosis. We aimed to evaluate the efficacy and safety of transbronchial lung biopsy using radial endobronchial ultrasound and virtual bronchoscopic navigation (TBLB-rEBUS&VBN) and CT-guided transthoracic needle biopsy (CT-TNB) for tissue diagnosis of small PLs.A systematic search was performed in five electronic databases, including MEDLINE, EMBASE, Cochrane Library Central Register of Controlled Trials, Web of Science, and Scopus, for relevant studies in May 2016; the selected articles were assessed using meta-analysis. The articles were limited to those published after 2000 that studied small PLs ≤ 3 cm in diameter.From 7345 records, 9 articles on the bronchoscopic (BR) approach and 15 articles on the percutaneous (PC) approach were selected. The pooled diagnostic yield was 75% (95% confidence interval [CI], 69-80) using the BR approach and 93% (95% CI, 90-96) using the PC approach. For PLs ≤ 2 cm, the PC approach (pooled diagnostic yield: 92%, 95% CI: 88-95) was superior to the BR approach (66%, 95% CI: 55-76). However, for PLs > 2 cm but ≤ 3 cm, the diagnostic yield using the BR approach was improved to 81% (95% CI, 75-85). Complications of pneumothorax and hemorrhage were rare with the BR approach but common with the PC approach.CT-TNB was superior to TBLB-rEBUS&VBN for the evaluation of small PLs. However, for lesions greater than 2 cm, the BR approach may be considered considering its diagnostic yield of over 80% and the low risk of procedure-related complications.http://europepmc.org/articles/PMC5777651?pdf=render |
| spellingShingle | Yeji Han Hyun Jung Kim Kyoung Ae Kong Soo Jung Kim Su Hwan Lee Yon Ju Ryu Jin Hwa Lee Yookyoung Kim Sung Shine Shim Jung Hyun Chang Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis. PLoS ONE |
| title | Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis. |
| title_full | Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis. |
| title_fullStr | Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis. |
| title_full_unstemmed | Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis. |
| title_short | Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis. |
| title_sort | diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus ct guided transthoracic needle biopsy a systematic review and meta analysis |
| url | http://europepmc.org/articles/PMC5777651?pdf=render |
| work_keys_str_mv | AT yejihan diagnosisofsmallpulmonarylesionsbytransbronchiallungbiopsywithradialendobronchialultrasoundandvirtualbronchoscopicnavigationversusctguidedtransthoracicneedlebiopsyasystematicreviewandmetaanalysis AT hyunjungkim diagnosisofsmallpulmonarylesionsbytransbronchiallungbiopsywithradialendobronchialultrasoundandvirtualbronchoscopicnavigationversusctguidedtransthoracicneedlebiopsyasystematicreviewandmetaanalysis AT kyoungaekong diagnosisofsmallpulmonarylesionsbytransbronchiallungbiopsywithradialendobronchialultrasoundandvirtualbronchoscopicnavigationversusctguidedtransthoracicneedlebiopsyasystematicreviewandmetaanalysis AT soojungkim diagnosisofsmallpulmonarylesionsbytransbronchiallungbiopsywithradialendobronchialultrasoundandvirtualbronchoscopicnavigationversusctguidedtransthoracicneedlebiopsyasystematicreviewandmetaanalysis AT suhwanlee diagnosisofsmallpulmonarylesionsbytransbronchiallungbiopsywithradialendobronchialultrasoundandvirtualbronchoscopicnavigationversusctguidedtransthoracicneedlebiopsyasystematicreviewandmetaanalysis AT yonjuryu diagnosisofsmallpulmonarylesionsbytransbronchiallungbiopsywithradialendobronchialultrasoundandvirtualbronchoscopicnavigationversusctguidedtransthoracicneedlebiopsyasystematicreviewandmetaanalysis AT jinhwalee diagnosisofsmallpulmonarylesionsbytransbronchiallungbiopsywithradialendobronchialultrasoundandvirtualbronchoscopicnavigationversusctguidedtransthoracicneedlebiopsyasystematicreviewandmetaanalysis AT yookyoungkim diagnosisofsmallpulmonarylesionsbytransbronchiallungbiopsywithradialendobronchialultrasoundandvirtualbronchoscopicnavigationversusctguidedtransthoracicneedlebiopsyasystematicreviewandmetaanalysis AT sungshineshim diagnosisofsmallpulmonarylesionsbytransbronchiallungbiopsywithradialendobronchialultrasoundandvirtualbronchoscopicnavigationversusctguidedtransthoracicneedlebiopsyasystematicreviewandmetaanalysis AT junghyunchang diagnosisofsmallpulmonarylesionsbytransbronchiallungbiopsywithradialendobronchialultrasoundandvirtualbronchoscopicnavigationversusctguidedtransthoracicneedlebiopsyasystematicreviewandmetaanalysis |