Radial-EBUS: CryoBiopsy Versus Conventional Biopsy: Time-Sample and C-Arm

Area of Science:

• Pulmonology
• Interventional Radiology
• Oncology

Background:

• Accurate diagnosis of lung nodules is crucial for patient management.
• Computed tomography (CT) and positron emission tomography (PET) scans are used to identify nodule origins.
• Minimally invasive biopsy techniques are essential for obtaining tissue samples.

Purpose of the Study:

• To compare the effectiveness of different biopsy methods for lung nodules.
• To evaluate sample yield based on nodule size, location, and biopsy technique.
• To assess the impact of C-arm navigation on procedure time.

Main Methods:

• Retrospective study of 248 patients with lung nodules (≥1 cm).
• Comparison of radial-endobronchial ultrasound with a 1.1 mm cryoprobe, 22G needle, and forceps/brush.
• Analysis of sample size (cell-block slices) in relation to biopsy method, nodule size, and location.
• Evaluation of procedure time with and without C-arm navigation.

Main Results:

• Central lesions yielded similar sample sizes across all biopsy methods.
• Cryobiopsies resulted in smaller sample sizes for peripheral lesions, associated with higher pneumothorax rates.
• Larger (≥2 cm) and central nodules produced more cell-blocks irrespective of the biopsy method.
• C-arm navigation significantly reduced procedure time.

Conclusions:

• Nodule size and location are key factors influencing biopsy sample yield.
• Cryobiopsy may be less suitable for peripheral lung nodules due to complications.
• C-arm navigation improves efficiency in lung nodule biopsy procedures.