Related Experiment Video
Updated: Jul 4, 2026
Robotic-assisted Bronchoscopy Combined with Multimodal Imaging for Targeted Lung Cryobiopsies
Published on: July 19, 2024
Use of Bronchoscopic Cryobiopsy in Evaluating Interstitial Lung Disease: Radiologic Predictors of Diagnostic Yield
Antonios Charokopos1, Argyrios Tzouvelekis2, Benjamin Stultz3
1Division of Pulmonary and Critical Care Medicine; Department of Respiratory Medicine, University of Patras, School of Medicine, Patras, Greece.
Objective:
To identify radiologic computed tomography predictors of increased diagnostic yield and fewer complications in transbronchial lung cryobiopsy (TBCB).
Methods:
We retrospectively reviewed computed tomography scans of 143 patients (51.7% female; mean age 62.7 years) who underwent TBCB at Mayo Clinic (January 1, 2017, to July 31, 2020). Multivariable logistic regression evaluated whether imaging, pulmonary function, and procedural parameters predicted diagnostic yield and complications.
Results:
Procedural complications included clinically significant bleeding (10.5%), pneumothorax (7.0%), and escalation of care (8.4%), with zero procedure-related deaths. Trainee presence did not affect the rate of clinically significant bleeding (10.5% vs 9.4%, P=.999) or whether the biopsy yielded a specific histopathologic diagnosis (61.9% vs 65.6%, P=.703). Abnormal histopathologic findings were found in 87.4% of cases, with 62.2% of biopsy specimens sufficiently identifying a specific diagnosis even when reviewed in isolation. Radiologic honeycombing was associated with an 82% lower yield on histopathology (adjusted odds ratio [aOR], 0.18; 95% CI, 0.05 to 0.68), despite higher number of passes. Higher diffusing capacity of the lungs for carbon monoxide was associated with lower complication rate (aOR, 0.95; 95% CI, 0.92 to 0.99), whereas higher forced expiratory volume in 1 second was associated with improved histopathologic yield (aOR, 1.02; 95% CI, 1.01 to 1.04).
Conclusion:
Computed tomography imaging and pulmonary function parameters influence diagnostic yield and complication rates for TBCB in interstitial lung disease. Radiologic honeycombing was a negative independent predictor of TBCB histopathologic yield, and clinicians should weigh whether TBCB in such cases provides incremental diagnostic value over integration of clinical and imaging data alone. Better lung function was associated with improved yield and lower complication risk. These findings may help refine patient selection and procedural planning.
