Related Experiment Video For Cryobiopsy
Updated: Jan 8, 2026
Author Spotlight: Expanding Interventional Pulmonology Research with Robotic-Assisted Bronchoscopy
Published on: July 19, 2024
A Prospective Study of Safety and the Incremental Diagnostic Value of Transbronchial Cryobiopsy Incorporated into
Bryan C Husta1, Kimia G Ganjaei1, Andrea Knezevic2
1Section of Interventional Pulmonology, Pulmonary Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
Background:
Shape-sensing robotic-assisted bronchoscopy (ssRAB) combined with intraoperative imaging optimizes tool-lesion relationship during the sampling of focal pulmonary lesions. Nevertheless, confirmation of tool-in-lesion status is not equivalent to diagnostic sampling. This gap may be bridged by the addition of transbronchial cryobiopsy (TBCB) to traditional transbronchial needle aspiration (TBNA) and forceps biopsy (TBFB); however, the performance of TBCB, specifically with the 1.7-mm cryoprobe, has raised significant safety concerns.
Objective:
Evaluate the safety of TBCB using the 1.7-mm cryoprobe, added into ssRAB-guided TBNA and TBFB, and performed via a protocolized approach in a cancer center patient population undergoing lung biopsy for focal parenchymal pulmonary lesions. Secondary endpoints included diagnostic yield, accuracy, and TBFB vs. TBCB tissue quality measures.
Methods:
This prospective, single center, single arm study, enrolled patients referred for sampling of focal pulmonary parenchymal lesions. All procedures were performed with image-guided ssRAB with prophylactic balloon occlusion. The primary endpoint was a safety composite of grade ≥ 2 bleeding, grade ≥ 2 pneumothorax, or other biopsy-related grade ≥ 3 complication. Secondary endpoints included conservative diagnostic yield, diagnostic accuracy for malignancy, and biopsy specimen quality measures.
Results:
Fifty-one participants were enrolled and underwent image-guided ssRAB. The primary severe adverse event rate was 0% (95% CI 0.0-7.9). The conservative diagnostic yield was 92% and the diagnostic accuracy for malignancy was 90%. TBCB was superior to forceps biopsy in measures of total specimen dimensions, diagnostic tissue area, and degree of crush artifact (P < 0.001 for all comparisons).
Conclusion:
In cancer patients with localized parenchymal lung lesions, the incorporation of a rigorous safety protocol into image-guided ssRAB allows for the safe acquisition of high-quality peripheral lung TBCB specimen, utilizing the 1.7-mm cryoprobe.
Clinical Trial Registration:
Clinicaltrials.gov identifier: NCT04548830.
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