Transbronchial lung cryobiopsy guided by radial miniature probe EBUS in interstitial lung diseases – Polish experience
M. Gnass*a (Dr), A. Filareckaa (Dr), J. Sojab (Prof), A. ćmielc (Prof), A. Bartczaka (Dr), D. Czyżewskid (Prof), A. Szlubowskia (Prof)
a Pulmonary Hospital in Zakopane, Zakopane, POLAND ; b Jagiellonian University in Cracow, Cracow, POLAND ; c Department of Applied Mathematics, AGH University of Science and Technology, Cracow, POLAND ; d Medical University of Silesia, Katowice, POLAND
* m.gnass@gmail.com
INTRODUCTION: Transbronchial lung cryobiopsy (TBLC) most often is performed in intubated patient with fluoroscopic control. The histological yield of TBLC reaches 80%. Pneumothorax and bronchial bleeding are the main complications.
OBJECTIVES: In our pulmonology centers intubation and fluoroscopy are not used for TBLC and biopsy site is selected according to lung CT and radial EBUS findings (both opacities and vessels). 5 years after introducing this methodology we examined efficacy and safety profile of this approach. Our hypothesis was that the type of interstitial lung disease (ILD) influences the diagnostic yield of TBLC.
METHODS: A multicenter Polish retrospective study to analyze the influence of cryobiopsy on the final diagnosis and complications in patients with granulomatous and other ILDs was conducted.
RESULTS: 173 patients (M:85,F:88) of mean age (SD) 54.4 (13.5) years underwent TBLC since March 2017 to April 2022. 87 due to suspicion of granulomatous ILD (sarcoidosis, HP, TBC) and 86 due to other ILDs. Sensitivity and accuracy of TBLC in both groups were 93.9%, 94.3% and 64,3%, 65%, respectively and significantly higher for granulomatous ILDs (p<0,05); overall were 78.9% and 79,8%. Pneumothorax occurred in 4.6% in the first and 4.7% in the second group. No severe or moderate bleeding was observed.
CONCLUSIONS: TBLC without intubation and fluoroscopy control guided by radial EBUS miniature probe is safe and has similar yield to other modalities. The type of suspected disease has the biggest impact on biopsy efficacy.
Disclosure of funding source(s): none