Diagnostic value of radial endobronchial ultrasound guide sheath transbronchial lung biospy in peripheral pulmonary lesions_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

CHENG Yuan , ZHANG Hong , ZHANG Wei , LI Nan , LIU Ying , GONG Yuhong ,  WANG Guangfa

Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, 100034, P.R.China;

Corresponding author：

WANG Guangfa, Email: wangguangfa@hotmail.com

Keywords：

Radial endobronchial ultrasound; Peripheral pulmonary lesions; Guide sheath

DOI：

10.7507/1671-6205.201610037

Video：

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Objective To evaluate the role of guide sheath (GS) utilization in radial endobronchial ultrasound guided transbronchial lung biopsy (EBUS-TBLB) for diagnosis of peripheral pulmonary lesions (PPLs). Methods The clinical data of patients who underwent EBUS-TBLB in Peking University First Hospital from July 2012 to June 2015 were retrospectively reviewed. The patients were divided into three groups,ie. a GS group, a non-GS group, and a double biopsy group. Results A total of 118 patients with 126 PPLs were collected. The overall diagnostic yield of EBUS-guided bronchoscopy was 60.3%. The diagnostic yield of GS group, non-GS group and double biopsy group was 65.4%(36/55), 61.5%(8/13), 59.6%(31/52), respectively. The diagnostic yield of the non-GS group was significantly lower than other two groups when PPLs≤20 mm (χ²=6.8,P=0.033), whereas no significant difference was observed when PPLs>20 mm (χ²=2.301,P=0.301). Conclusion GS significantly improves diagnostic yield in EBUS-TBLB when PPLs≤20 mm.

Citation： CHENG Yuan, ZHANG Hong, ZHANG Wei, LI Nan, LIU Ying, GONG Yuhong, WANG Guangfa. Diagnostic value of radial endobronchial ultrasound guide sheath transbronchial lung biospy in peripheral pulmonary lesions. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(2): 160-164. doi: 10.7507/1671-6205.201610037 Copy

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2.	Herth FJ, Ernst A, Becker HD. Endobronchial ultrasound-guided transbronchial lung biopsy in solitary pulmonary nodules and peripheral lesions. Eur Respir J, 2002, 20(4): 972-974.
3.	Kurimoto N, Miyazawa T, Okimasa S, et al. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically. Chest, 2004, 126(3): 959-965.
4.	Shirakawa T, Imamura F, Hamamoto J, et al. Usefulness of endobronchial ultrasonography for transbronchial lung biopsies of peripheral lung lesions. Respiration, 2004, 71(3): 260-268.
5.	Asahina H, Yamazaki K, Onodera Y, et al. Transbronchial biopsy using endobronchial ultrasonography with a guide sheath and virtual bronchoscopic navigation. Chest, 2005, 128(3): 1761-1765.
6.	Yoshikawa M, Sukoh N, Yamazaki K, et al. Diagnostic value of endobronchial ultrasonography with a guide sheath for peripheral pulmonary lesions without X-ray fluoroscopy. Chest, 2007, 131(6): 1788-1793.
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10.	Yamada N, Yamazaki K, Kurimoto N, et al. Factors related to diagnostic yield of transbronchial biopsy using endobronchial ultrasonography with a guide sheath in small peripheral pulmonary lesions. Chest, 2007, 132(2): 603-608.
11.	中华医学会呼吸病学分会. 支气管镜诊疗操作相关大出血的预防和救治专家共识. 中华结核和呼吸杂志, 2016, 39(8): 588-591.
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13.	王昌国, 曾大雄, 雷伟, 等. CT 引导下经皮肺穿刺与超声引导下经支气管镜肺活检对肺周围型病变的诊断价值. 中华结核和呼吸杂志, 2015, 38(12): 897-900.
14.	Steinfort DP, Khor YH, Manser RL, et al. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis. Eur Respir J, 2011, 37(4): 902-910.
15.	李明, 彭爱梅, 张国良, 等. 支气管超声下经引导鞘肺活检术诊断肺周围性病变的价值. 中华结核和呼吸杂志, 2014, 37(1): 36-40.
16.	唐纯丽, 罗为展, 钟长镐, 等. 径向超声联合虚拟导航引导肺活检对肺外周结节的诊断价值. 中华结核和呼吸杂志, 2016, 39(1): 38-40.
17.	Chavez C, Sasada S, Izumo T, et al. Endobronchial ultrasound with a guide sheath for small malignant pulmonary nodules: a retrospective comparison between central and peripheral locations. J Thorac Dis, 2015, 7(4): 596-602.

1. Oki M, Saka H, Kitagawa C, et al. Novel thin bronchoscope with a 1.7-mm working channel for peripheral pulmonary lesions. Eur Respir J, 2008, 32(2): 465-471.
2. Herth FJ, Ernst A, Becker HD. Endobronchial ultrasound-guided transbronchial lung biopsy in solitary pulmonary nodules and peripheral lesions. Eur Respir J, 2002, 20(4): 972-974.
3. Kurimoto N, Miyazawa T, Okimasa S, et al. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically. Chest, 2004, 126(3): 959-965.
4. Shirakawa T, Imamura F, Hamamoto J, et al. Usefulness of endobronchial ultrasonography for transbronchial lung biopsies of peripheral lung lesions. Respiration, 2004, 71(3): 260-268.
5. Asahina H, Yamazaki K, Onodera Y, et al. Transbronchial biopsy using endobronchial ultrasonography with a guide sheath and virtual bronchoscopic navigation. Chest, 2005, 128(3): 1761-1765.
6. Yoshikawa M, Sukoh N, Yamazaki K, et al. Diagnostic value of endobronchial ultrasonography with a guide sheath for peripheral pulmonary lesions without X-ray fluoroscopy. Chest, 2007, 131(6): 1788-1793.
7. Asano F. Advanced bronchoscopy for the diagnosis of peripheral pulmonary lesions. Respir Investig, 2016, 54(4): 224-229.
8. Khan KA, Nardelli P, Jaeger A, et al. Navigational bronchoscopy for early lung cancer: a road to therapy. Adv Ther, 2016, 33(4): 580-596.
9. Yasufuku K, Nakajima T, Chiyo M, et al. Endobronchial ultrasonography: current status and future directions. J Thorac Oncol, 2007, 2(10): 970-979.
10. Yamada N, Yamazaki K, Kurimoto N, et al. Factors related to diagnostic yield of transbronchial biopsy using endobronchial ultrasonography with a guide sheath in small peripheral pulmonary lesions. Chest, 2007, 132(2): 603-608.
11. 中华医学会呼吸病学分会. 支气管镜诊疗操作相关大出血的预防和救治专家共识. 中华结核和呼吸杂志, 2016, 39(8): 588-591.
12. Rivera MP, Mehta AC, Wahidi MM. Establishing the diagnosis of lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e142S-165S.
13. 王昌国, 曾大雄, 雷伟, 等. CT 引导下经皮肺穿刺与超声引导下经支气管镜肺活检对肺周围型病变的诊断价值. 中华结核和呼吸杂志, 2015, 38(12): 897-900.
14. Steinfort DP, Khor YH, Manser RL, et al. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis. Eur Respir J, 2011, 37(4): 902-910.
15. 李明, 彭爱梅, 张国良, 等. 支气管超声下经引导鞘肺活检术诊断肺周围性病变的价值. 中华结核和呼吸杂志, 2014, 37(1): 36-40.
16. 唐纯丽, 罗为展, 钟长镐, 等. 径向超声联合虚拟导航引导肺活检对肺外周结节的诊断价值. 中华结核和呼吸杂志, 2016, 39(1): 38-40.
17. Chavez C, Sasada S, Izumo T, et al. Endobronchial ultrasound with a guide sheath for small malignant pulmonary nodules: a retrospective comparison between central and peripheral locations. J Thorac Dis, 2015, 7(4): 596-602.

Chinese Journal of Respiratory and Critical Care Medicine

Diagnostic value of radial endobronchial ultrasound guide sheath transbronchial lung biospy in peripheral pulmonary lesions

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