Using superDimension as navigation when performing cryobiopsies: a randomised-controlled study

Interstitial lung disease (ILD) encompasses a range of pulmonary diseases characterized by inflammation and fibrosis. Diagnosing ILD often requires invasive procedures, including transbronchial cryobiopsy (TBCB). Fluoroscopy (FS) is the standard imaging method for guiding these procedures, but newer technologies such as electromagnetic navigation like superDimension (SD) may offer greater precision. This study aimed to compare the complication rates, diagnostic yield, and biopsy quality between FS-guided and SD-guided TBCB in patients under investigation for ILD.

This was a prospective and randomized study. Patients suspect of ILD with difficult-to-reach biopsy targets were randomly assigned to either FS- or SD-guided TBCB. Complications, diagnostic yield, and biopsy quality were compared.

The SD-guided group had a significantly longer procedure time (62 vs. 44 min, p = 0.0004). More biopsies were taken from the planned target (93 % vs. 41 %, p = 0.007) and the biopsies contributed more frequently to the final diagnosis in the SD group (93 % vs. 61 %, p = 0.032). No significant differences were found in complication rates nor in diagnostic yield.

Our study highlights the potential advantages of SD in specific clinical contexts, though further research with larger sample sizes is needed to fully assess its benefits. Both techniques demonstrated comparable safety profiles, suggesting their suitability in clinical practice depending on lesion characteristics.