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Published on: June 16, 2020
Cryobiopsy versus open lung biopsy in the diagnosis of interstitial lung disease (COLDICE): protocol of a multicentre
Lauren K Troy1,2, Christopher Grainge3,4, Tamera Corte1,2
1Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Insights
The COLDICE study compared transbronchial lung cryobiopsy (TBLC) with surgical lung biopsy for interstitial lung disease diagnosis. Results will determine TBLC
Area of Science:
- Pulmonology
- Thoracic Surgery
- Pathology
Background:
- Transbronchial lung cryobiopsy (TBLC) is an emerging minimally invasive method for interstitial lung disease (ILD) diagnosis.
- The diagnostic accuracy of TBLC compared to traditional methods remains uncertain.
- Establishing TBLC's reliability is crucial for its clinical adoption in ILD management.
Purpose of the Study:
- To evaluate the diagnostic accuracy of TBLC against surgical lung biopsy in patients with ILD.
- To assess the agreement between TBLC and VATS biopsy for both histopathological and multidisciplinary discussion (MDD) diagnoses.
- To compare the diagnostic yield of TBLC and VATS within a single anesthetic episode.
Main Methods:
- A comparative, multicentre, prospective trial enrolling ILD patients requiring surgical lung biopsy.
- Concurrent TBLC and video-assisted thoracoscopic surgical (VATS) biopsy performed in the same anesthetic session.
- Blinded histopathological assessment by expert pathologists and blinded multidisciplinary discussion (MDD) of anonymized data.
Main Results:
- The study is designed to measure the agreement between TBLC and VATS biopsy diagnoses.
- Interobserver agreement among pathologists and MDD participants will be analyzed.
- Data on clinical and procedural characteristics will be collected to contextualize findings.
Conclusions:
- The COLDICE study will provide critical data on the diagnostic accuracy of TBLC for ILD.
- Findings will inform the clinical utility of TBLC as a less invasive alternative to surgical biopsy.
- The study aims to establish TBLC's role in the diagnostic pathway for interstitial lung diseases.
Introduction:
Transbronchial lung cryobiopsy (TBLC) is a novel, minimally invasive technique for obtaining lung tissue for histopathological assessment in interstitial lung disease (ILD). Despite its increasing popularity, the diagnostic accuracy of TBLC is not yet known. The COLDICE Study (Cryobiopsy versus Open Lung biopsy in the Diagnosis of Interstitial lung disease allianCE) aims to evaluate the agreement between TBLC and surgical lung biopsy sampled concurrently from the same patients, for both histopathological and multidisciplinary discussion (MDD) diagnoses.
Methods And Analysis:
This comparative, multicentre, prospective trial is enrolling patients with ILD requiring surgical lung biopsy to aid with their diagnosis. Participants are consented for both video-assisted thoracoscopic surgical (VATS) biopsy and TBLC within the same anaesthetic episode. Specimens will be blindly assessed by three expert pathologists both individually and by consensus. Each tissue sample will then be considered in conjunction with clinical and radiological data, within a centralised MDD. Each patient will be presented twice in random order, once with TBLC data and once with VATS data. Meeting participants will be blinded to the method of tissue sampling. The accuracy of TBLC will be assessed by agreement with VATS at (1) histopathological analysis and (2) MDD diagnosis. Data will be collected on interobserver agreement between pathologists, interobserver agreement between MDD participants, and detailed clinical and procedural characteristics.
Ethics And Dissemination:
The study is being conducted in accordance with the International Conference on Harmonisation Guideline for Good Clinical Practice and Australian legislation for the ethical conduct of research.
Trial Registration Number:
ACTRN12615000718549.
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