Cone Beam Computed Tomography improves the precise location of the probe when performing transbronchial cryobiopsy in interstitial lung disease
G. Vignigni*a (Dr), A. Vizzusob (Dr), S. Piciucchib (Dr), A. Dubinic (Dr), A. Ambrosini Spaltroc (Dr), AJ. De Grauwa (Dr), F. Sultania (Dr), S. Martinelloa (Dr), C. Ghirottia (Dr), V. Polettia (Prof), C. Ravagliaa (Prof)
a Department of Pulmonology, "G.B. Mogagni- L. Pierantoni" Hospital, Forlì, ITALY ; b Department of Radiology, "G.B. Mogagni- L. Pierantoni" Hospital, Forlì, ITALY ; c Department of Pathology, "G.B. Mogagni- L. Pierantoni" Hospital, Forlì, ITALY
Background: Transbronchial lung cryobiopsy (TBLC) is considered now a valid alternative to surgical lung biopsy for the diagnosis of interstitial lung diseases. However, the precise location of the probe and the exact distance from the pleura are sometimes difficult to establish.
Methods: This is a prospective observational monocentric study. Our aim is to find out feasibility and safety of cryobiopsy when performed under Cone Beam 3D CT (CBCT) guide.Patients with suspected diffuse parenchymal lung disease undergoing cone beam CT-guided cryobiopsy are prospectively enrolled. All demographic data, lung function tests, imaging patterns, biopsy characteristics, diagnostic yield and complications are collected. Bronchoscopies are performed through a rigid tube, under general anesthesia, in a hybrid CBCT operation room. 3D CT images are acquired and reviewed in axial, coronal and sagittal planes to accurately assess the cryoprobe position. Cryobiopsy is performed with 1.7 mm probe following probe positioning and, after each biopsy, Fogarty balloon is immediately inflated to prevent bleeding.
Results: 11 patients have been prospectively recruited until now. Enrollment will end when 30 patients will be reached. Median age was 67 years. Median FVC was 87% predicted, median DLCO was 71% predicted. A final multidisciplinary diagnosis was obtained in 100% of cases. Three patients (27%) developed a pneumothorax, which required a pleural drainage. No severe/moderate bleeding was observed.
Conclusions: CBCT-guided TBLC in patients with ILDs is associated with a promising diagnostic yield and an acceptable safety profile. A larger trial is necessary to validate the results.
Disclosure of funding source(s): none