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Vol.84 No.4
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Radial Probe Endobronchial Ultrasound Using Guide Sheath-Guided Transbronchial Lung Biopsy in Peripheral Pulmonary Lesions without Fluoroscopy

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2021, v.84 no.4, pp.282-290
https://doi.org/10.4046/trd.2021.0002

Ahn Heeyun (Yeungnam University)
Lee Kwan Ho (Yeungnam University)

Shin Kyeong-Cheol (Division of Pulmonology and Allergy, Department of Internal Medicine, College of Medicine, Yeungnam University and Respiratory Center, Yeungnam University Medical Center, Daegu, Korea.)
Jin Hyun Jung (Department of Internal Medicine, Medical School of Yeungnam University, Daegu, Korea.)

Lee Seok Soo (Yeungnam University)
Jang Min Hye (Yeungnam University)

Ahn, H. , Lee, K. H. , Shin, K. , Jin, H. J. , Lee, S. S. , Jang, M. H. , & (2021). Radial Probe Endobronchial Ultrasound Using Guide Sheath-Guided Transbronchial Lung Biopsy in Peripheral Pulmonary Lesions without Fluoroscopy. Tuberculosis & Respiratory Diseases, 84(4), 282-290, https://doi.org/10.4046/trd.2021.0002
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Abstract

Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) has improved the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPLs). The diagnostic yield and complications of RP-EBUS-TBLB for PPLs vary depending on the technique, such as using a guide sheath (GS) or fluoroscopy. In this study, we investigated the utility of RP-EBUS-TBLB using a GS without fluoroscopy for diagnosing PPLs.Methods: We retrospectively reviewed data from 607 patients who underwent RP-EBUS of PPLs from January 2019 to July 2020. TBLB was performed using RP-EBUS with a GS without fluoroscopy. The diagnostic yield and complications were assessed. Multivariable logistic regression analyses were used to identify factors affecting the diagnostic yields.Results: The overall diagnostic accuracy was 76.1% (462/607). In multivariable analyses, the size of the lesion (≥20 mm; odds ratio [OR], 2.06; 95% confidence interval [CI], 1.27–3.33; p=0.003), positive bronchus sign in chest computed tomography (OR, 2.30; 95% CI, 1.40–3.78; p=0.001), a solid lesion (OR, 2.40; 95% CI, 1.31–4.41; p=0.005), and an EBUS image with the probe within the lesion (OR, 6.98; 95% CI, 4.38–11.12; p<0.001) were associated with diagnostic success. Pneumothorax occurred in 2.0% (12/607) of cases and chest tube insertion was required in 0.5% (3/607) of patients.Conclusion: RP-EBUS-TBLB using a GS without fluoroscopy is a highly accurate diagnostic method in diagnosing PPLs that does not involve radiation exposure and has acceptable complication rates.

keywords
Bronchoscopy, Diagnosis, Peripheral, Ultrasonography

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