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[Transbronchial cryobiopsy in diffuse interstitial lung diseases]

J Camuset1, J M Naccache2, X Dhalluin3

  • 1Service de chirurgie thoracique, hôpital Tenon, CHU, AP-HP, 4, rue de la Chine, 75020 Paris, France.

Revue Des Maladies Respiratoires
|April 22, 2019
PubMed

Insights

Transbronchial cryobiopsy (TBC) shows promise for diagnosing interstitial lung disease (ILD), achieving a 54.2% diagnostic yield in a preliminary study. Further research is needed to confirm its safety and effectiveness compared to surgical lung biopsy.

Area of Science:

  • Pulmonology
  • Interventional Pulmonology
  • Diagnostic Procedures

Background:

  • Interstitial lung disease (ILD) diagnosis often requires invasive procedures.
  • Transbronchial cryobiopsy (TBC) presents a potential alternative to surgical lung biopsy (SLB).
  • Preliminary data on TBC's effectiveness and safety in ILD diagnosis is limited.

Purpose of the Study:

  • To evaluate the diagnostic effectiveness of TBC in ILD patients.
  • To assess the safety profile of TBC in the context of ILD diagnosis.
  • To report preliminary experience from two French university centers.

Main Methods:

  • Twenty-four patients with ILD underwent TBC between 2014 and 2017.
  • Histological diagnoses were reviewed and validated through multidisciplinary discussions (MDD).
  • Average of 3 TBC samples were obtained per patient.

Main Results:

  • Analyzable TBC samples were obtained in 91.7% of patients.
  • Histological diagnosis was achieved in 63.6% of analyzable samples, with 59% certainty after MDD.
  • Overall diagnostic yield was 54.2%, with complications including pneumothorax (37.5%) and bleeding (20.8%).

Conclusions:

  • TBC demonstrates potential for ILD diagnosis, with improved diagnostic yield observed after an initial learning curve (80% after 2015).
  • Complication rates require careful consideration.
  • A prospective randomized study is necessary to definitively establish TBC's diagnostic performance and safety compared to SLB in France.
Abstract

Keywords:
Biopsie pulmonaire chirurgicaleBronchoscopie rigideCryobiopsies trans-bronchiquesCryobiopsyInterstitial lung diseaseInterventional pulmonologyPneumologie interventionnellePneumopathie interstitielle diffuseRigid bronchoscopySurgical lung biopsy

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