The cryobiopsy in interstitial lung diseases guided by probe‐based confocal laser endomicroscopy is feasible

Abstract Background Transbronchial lung cryobiopsy (TBLB) is routinely used to diagnose the interstitial lung disease (ILD). These results are consistent with those of surgical lung biopsy. Fluoroscopy is also used to confirm the final position of the cryoprobe; however, it can increase radiation ex...

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Main Authors: Yu Zheng, Liyan Zhang, Yueyan Lou, Bijun Fan, Yongqi Cui, Xueling Wu, Xiaoming Tan
Format: Article
Language:English
Published: Wiley 2023-10-01
Series:The Clinical Respiratory Journal
Subjects:
Online Access:https://doi.org/10.1111/crj.13669
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author Yu Zheng
Liyan Zhang
Yueyan Lou
Bijun Fan
Yongqi Cui
Xueling Wu
Xiaoming Tan
author_facet Yu Zheng
Liyan Zhang
Yueyan Lou
Bijun Fan
Yongqi Cui
Xueling Wu
Xiaoming Tan
author_sort Yu Zheng
collection DOAJ
description Abstract Background Transbronchial lung cryobiopsy (TBLB) is routinely used to diagnose the interstitial lung disease (ILD). These results are consistent with those of surgical lung biopsy. Fluoroscopy is also used to confirm the final position of the cryoprobe; however, it can increase radiation exposure for both patients and medical care personnel. Probe‐based confocal laser endomicroscopy (pCLE) is a novel optical imaging technique that allows real‐time imaging at the cellular level in vivo. pCLE technology can also be used to identify malignancy, acute rejection in lung transplantation, amiodarone lung, and pulmonary alveolar proteinosis and visualize elastin fibres in the alveolar compartment. Objectives The aim of this study is to investigate the ability of pCLE to distinguish fibrotic pulmonary issues from normal lung disease and the safety and feasibility of CLE‐guided bronchoscopy and transbronchial lung cryobiopsy (TBLC) in patients with interstitial lung disease (ILD). Methods pCLE images from 17 ILD patients were obtained during TBLB. These images were then compared with histology results to assess the correspondence rate. Results pCLE imaging of the alveolar structures was performed. Key characteristics were visible, which could potentially influence the diagnostic rate (fibrotic areas) and the complication rate (blood vessel and pleura). Conclusion pCLE may reduce complications and increase the diagnostic yield. It is a potential guidance tool for cryobiopsy in the patients with ILD without fluoroscopy.
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spelling doaj.art-8ddc194706bd453e880ea4574f26cba82023-10-02T06:33:21ZengWileyThe Clinical Respiratory Journal1752-69811752-699X2023-10-011710998100510.1111/crj.13669The cryobiopsy in interstitial lung diseases guided by probe‐based confocal laser endomicroscopy is feasibleYu Zheng0Liyan Zhang1Yueyan Lou2Bijun Fan3Yongqi Cui4Xueling Wu5Xiaoming Tan6Department of Respiratory Medicine, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Respiratory Medicine, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Respiratory Medicine, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Respiratory Medicine, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Respiratory Medicine, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Respiratory Medicine, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Respiratory Medicine, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaAbstract Background Transbronchial lung cryobiopsy (TBLB) is routinely used to diagnose the interstitial lung disease (ILD). These results are consistent with those of surgical lung biopsy. Fluoroscopy is also used to confirm the final position of the cryoprobe; however, it can increase radiation exposure for both patients and medical care personnel. Probe‐based confocal laser endomicroscopy (pCLE) is a novel optical imaging technique that allows real‐time imaging at the cellular level in vivo. pCLE technology can also be used to identify malignancy, acute rejection in lung transplantation, amiodarone lung, and pulmonary alveolar proteinosis and visualize elastin fibres in the alveolar compartment. Objectives The aim of this study is to investigate the ability of pCLE to distinguish fibrotic pulmonary issues from normal lung disease and the safety and feasibility of CLE‐guided bronchoscopy and transbronchial lung cryobiopsy (TBLC) in patients with interstitial lung disease (ILD). Methods pCLE images from 17 ILD patients were obtained during TBLB. These images were then compared with histology results to assess the correspondence rate. Results pCLE imaging of the alveolar structures was performed. Key characteristics were visible, which could potentially influence the diagnostic rate (fibrotic areas) and the complication rate (blood vessel and pleura). Conclusion pCLE may reduce complications and increase the diagnostic yield. It is a potential guidance tool for cryobiopsy in the patients with ILD without fluoroscopy.https://doi.org/10.1111/crj.13669interstitial lung diseasesprobe‐based confocal laser endomicroscopyreal‐time imagingtransbrochial lung cryobiopsy
spellingShingle Yu Zheng
Liyan Zhang
Yueyan Lou
Bijun Fan
Yongqi Cui
Xueling Wu
Xiaoming Tan
The cryobiopsy in interstitial lung diseases guided by probe‐based confocal laser endomicroscopy is feasible
The Clinical Respiratory Journal
interstitial lung diseases
probe‐based confocal laser endomicroscopy
real‐time imaging
transbrochial lung cryobiopsy
title The cryobiopsy in interstitial lung diseases guided by probe‐based confocal laser endomicroscopy is feasible
title_full The cryobiopsy in interstitial lung diseases guided by probe‐based confocal laser endomicroscopy is feasible
title_fullStr The cryobiopsy in interstitial lung diseases guided by probe‐based confocal laser endomicroscopy is feasible
title_full_unstemmed The cryobiopsy in interstitial lung diseases guided by probe‐based confocal laser endomicroscopy is feasible
title_short The cryobiopsy in interstitial lung diseases guided by probe‐based confocal laser endomicroscopy is feasible
title_sort cryobiopsy in interstitial lung diseases guided by probe based confocal laser endomicroscopy is feasible
topic interstitial lung diseases
probe‐based confocal laser endomicroscopy
real‐time imaging
transbrochial lung cryobiopsy
url https://doi.org/10.1111/crj.13669
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