Diagnostic value of endobronchial ultrasound guide sheath transbronchial lung biopsy combined with rapid on-site evaluation for peripheral pulmonary lesions_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 XU Chunhua ^1,2 ,  ZHONG Jian ³ , WANG Wei ^1,2 , WANG Yuchao ^1,2 , LI Li ^1,2 , YUAN Qi ^1,2 , ZHANG Qian ^1,2 , CHI Chuanzhen ^1,2

1. Department of Respiratory Medicine, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P. R. China;
2. Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, P. R. China;
3. Department of Thoracic Surgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P. R. China;

Corresponding author：

XU Chunhua, Email: xuch2188@163.com; ZHONG Jian, Email: zhongjian_nj@163.com

Keywords：

Radial probe endobronchial ultrasound; transbronchial lung biopsy; rapid on-site evaluation; peripheral pulmonary lesions

DOI：

10.7507/1671-6205.202110004

Video：

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Objective To evaluate the diagnosis value of radial probe endobronchial ultrasound guide sheath transbronchial lung biopsy (RP-EBUS-GS-TBLB) combination with rapid on-site evaluation (ROSE) in peripheral pulmonary lesions (PPLs). Methods One hundred and fifty-eight patients with PPLs identified by computed tomography in Nanjing Chest Hospital underwent RP-EBUS-GS-TBLB with or without ROSE randomly between February 2016 and August 2017. The sensitivity, the procedure time, the biopsy times, and the complications were evaluated in the two groups. Results The diagnostic yield was 85.7% (72/84) in ROSE group and 70.3% (52/74) in No-ROSE group. There was significant difference in diagnostic sensitivity between the two groups (P<0.05). The mean procedure time and number of biopsy in ROSE group were less than those in No-ROSE group (P<0.01). No severe procedure related complications such as pneumothorax and hemoptysis were observed. Conclusions ROSE can improve the diagnostic sensitivity, and shorten the procedure time. RP-EBUS-GS-TBLB combined with ROSE is a safe and effective technique for PPLs.

Citation： XU Chunhua, ZHONG Jian, WANG Wei, WANG Yuchao, LI Li, YUAN Qi, ZHANG Qian, CHI Chuanzhen. Diagnostic value of endobronchial ultrasound guide sheath transbronchial lung biopsy combined with rapid on-site evaluation for peripheral pulmonary lesions. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(7): 493-497. doi: 10.7507/1671-6205.202110004 Copy

1.	River MP, Mehta AC. Diagnosis and management of lung cancer, 3rded: American college of chest physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5): 142-165.
2.	Davenport RD. Rapid on-site evaluation of transbronchial aspirates. Chest, 1990, 98(1): 59-61.
3.	Austin JH, Cohen MB. Value of having a cytopathologist present during percutaneous fine-needle aspiration biopsy of lung: report of 55 cancer patients and meta analysis of the literature. AJR Am J Roentgenol, 1993, 160(1): 175-177.
4.	Wohlschläger J, Darwiche K, Ting S, et al. Rapid on-site evaluation (ROSE) in cytological diagnostics of pulmonary and mediastinal diseases. Pathologe, 2012, 33(4): 308-315.
5.	李燕, 蔡后荣, 演欣, 等. 快速现场评价在肺占位病变良恶性判断中的作用. 中国呼吸与危重监护杂志, 2018, 17(5): 484-487.
6.	Diette GB, White P Jr, Terry P, et al. Utility of on-site cytopathology assessment for bronchoscopic evaluation of lung masses and adenopathy. Chest, 2000, 117(4): 1186-1190.
7.	Baram D, Garcia RB, Richman PS. Impact of rapid on-site cytologic evaluation during transbronchial needle aspiration. Chest, 2005, 128(2): 869-875.
8.	常立功, 田智丹, 谷伟, 等. 介入肺脏病学中快速现场评价常见判断陷阱与应用体会. 中国呼吸与危重监护杂志, 2021, 20(6): 432-436.
9.	Silverman JF, Frable WJ. The use of the diff-quik stain in the immediate interpretation of fine-needle aspiration biopsies. Diagn Cytopathol, 1990, 6(5): 366-369.
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.	李凯述, 刘明涛, 姜淑娟, 等. 经支气管镜针吸活检联合现场细胞学对肺癌诊断的临床价值. 中国肺癌杂志, 2014, 17(3): 215-220.
12.	Carr IM, Koegelenberg CF, von Groote-Bidlingmaier F, et al. Blood loss during flexible bronchoscopy: a prospective observational study. Respiration, 2012, 84(4): 312-318.
13.	Izumo T, Matsumoto Y, Sasada S, et al. Utility of rapid on-site cytologic evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions. Jpn J Clin Oncol, 2017, 47(3): 221-225.
14.	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.
15.	Diacon AH, Schuurmans MM, Theron J, et al. Utility of rapid on-site evaluation of transbronchial needle aspirates. Respiration, 2005, 72(2): 182-188.
16.	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.
17.	Dooms CA, Verbeken EK, Becker HD, et al. Endobronchial ultrasonography in bronchoscopic occult pulmonary lesions. J Thorac Oncol, 2007, 2(2): 121-124.
18.	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.
19.	Xu CH, Liu W, Wang W, et al. Diagnostic value of endobronchial ultrasound combined with rapid on-site evaluation of transbronchial lung biopsy for peripheral pulmonary lesions. Diagn Cytopathol, 2021, 49(6): 706-710.
20.	Hayama M, Okamoto N, Suzuki H, et al. Radial endobronchial ultrasound with a guide sheath for diagnosis of peripheral cavitary lung lesions: a retrospective study. BMC Pulm Med, 2016, 16(1): 76.
21.	Wallbridge PD, Hannan LM, Joosten SA, et al. Clinical utility of sequential venous blood gas measurement in the assessment of ventilatory status during physiological stress. Intern Med J, 2013, 43(10): 1075-1080.

1. River MP, Mehta AC. Diagnosis and management of lung cancer, 3rded: American college of chest physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5): 142-165.
2. Davenport RD. Rapid on-site evaluation of transbronchial aspirates. Chest, 1990, 98(1): 59-61.
3. Austin JH, Cohen MB. Value of having a cytopathologist present during percutaneous fine-needle aspiration biopsy of lung: report of 55 cancer patients and meta analysis of the literature. AJR Am J Roentgenol, 1993, 160(1): 175-177.
4. Wohlschläger J, Darwiche K, Ting S, et al. Rapid on-site evaluation (ROSE) in cytological diagnostics of pulmonary and mediastinal diseases. Pathologe, 2012, 33(4): 308-315.
5. 李燕, 蔡后荣, 演欣, 等. 快速现场评价在肺占位病变良恶性判断中的作用. 中国呼吸与危重监护杂志, 2018, 17(5): 484-487.
6. Diette GB, White P Jr, Terry P, et al. Utility of on-site cytopathology assessment for bronchoscopic evaluation of lung masses and adenopathy. Chest, 2000, 117(4): 1186-1190.
7. Baram D, Garcia RB, Richman PS. Impact of rapid on-site cytologic evaluation during transbronchial needle aspiration. Chest, 2005, 128(2): 869-875.
8. 常立功, 田智丹, 谷伟, 等. 介入肺脏病学中快速现场评价常见判断陷阱与应用体会. 中国呼吸与危重监护杂志, 2021, 20(6): 432-436.
9. Silverman JF, Frable WJ. The use of the diff-quik stain in the immediate interpretation of fine-needle aspiration biopsies. Diagn Cytopathol, 1990, 6(5): 366-369.
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. 李凯述, 刘明涛, 姜淑娟, 等. 经支气管镜针吸活检联合现场细胞学对肺癌诊断的临床价值. 中国肺癌杂志, 2014, 17(3): 215-220.
12. Carr IM, Koegelenberg CF, von Groote-Bidlingmaier F, et al. Blood loss during flexible bronchoscopy: a prospective observational study. Respiration, 2012, 84(4): 312-318.
13. Izumo T, Matsumoto Y, Sasada S, et al. Utility of rapid on-site cytologic evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions. Jpn J Clin Oncol, 2017, 47(3): 221-225.
14. 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.
15. Diacon AH, Schuurmans MM, Theron J, et al. Utility of rapid on-site evaluation of transbronchial needle aspirates. Respiration, 2005, 72(2): 182-188.
16. 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.
17. Dooms CA, Verbeken EK, Becker HD, et al. Endobronchial ultrasonography in bronchoscopic occult pulmonary lesions. J Thorac Oncol, 2007, 2(2): 121-124.
18. 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.
19. Xu CH, Liu W, Wang W, et al. Diagnostic value of endobronchial ultrasound combined with rapid on-site evaluation of transbronchial lung biopsy for peripheral pulmonary lesions. Diagn Cytopathol, 2021, 49(6): 706-710.
20. Hayama M, Okamoto N, Suzuki H, et al. Radial endobronchial ultrasound with a guide sheath for diagnosis of peripheral cavitary lung lesions: a retrospective study. BMC Pulm Med, 2016, 16(1): 76.
21. Wallbridge PD, Hannan LM, Joosten SA, et al. Clinical utility of sequential venous blood gas measurement in the assessment of ventilatory status during physiological stress. Intern Med J, 2013, 43(10): 1075-1080.

Chinese Journal of Respiratory and Critical Care Medicine

Diagnostic value of endobronchial ultrasound guide sheath transbronchial lung biopsy combined with rapid on-site evaluation for peripheral pulmonary lesions

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