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[Cryobiopsy in interstitial lung disease: a real-life experience from a single center in Argentina]
Joaquín Maritano Furcada1, Rodrigo Castro1, Juan A Precerutti1
1Sección de Neumonología, Hospital Italiano de Buenos Aires, Argentina.
Insights
Transbronchial lung cryobiopsy (TBLC) is a safe and effective method for diagnosing interstitial lung diseases. Increased sample number positively impacts diagnostic yield, highlighting its value in real-world clinical settings.
Area of Science:
- Pulmonology
- Interventional Pulmonology
- Diagnostic Pathology
Background:
- Interstitial lung diseases (ILDs) require accurate histological assessment.
- Transbronchial lung cryobiopsy (TBLC) is a newer technique for obtaining lung tissue.
- Real-world data on TBLC's efficacy and safety in ILD diagnosis is valuable.
Purpose of the Study:
- To evaluate the diagnostic yield of TBLC for interstitial lung diseases.
- To assess the safety and complication rates of TBLC in a clinical setting.
- To identify factors influencing diagnostic success in TBLC procedures.
Main Methods:
- Retrospective review of 52 patients undergoing TBLC for ILD from 2016-2019.
- Analysis of procedure characteristics, complications, and histopathological diagnoses.
- Multivariate logistic regression to determine factors associated with diagnosis and complications.
Main Results:
- TBLC yielded a 73.1% diagnostic rate via histology alone, increasing to 84.5% with multidisciplinary evaluation.
- Pneumothorax occurred in 25% of patients; no severe bleeding or deaths were reported.
- A higher number of samples obtained during TBLC was significantly associated with improved diagnostic yield (OR 2.15).
Conclusions:
- TBLC is a safe and effective tool for diagnosing interstitial lung diseases in a real-world setting.
- Multidisciplinary evaluation significantly enhances the diagnostic yield of TBLC.
- Optimizing the number of samples is crucial for maximizing diagnostic accuracy in TBLC procedures.
Abstract:
Cryobiopsy in interstitial lung disease: a real-life experience from a single center in Argentina. Transbronchial lung cryobiopsy (TBLC) has been recently introduced for the histological assessment of interstitial lung diseases. The objectives were to assess the diagnostic yield and safety of TBLC for interstitial lung diseases in our setting. A retrospective review of subjects who underwent TBLC in a tertiary care center from September 2016 to November 2019 was performed. Data regarding subject and procedure characteristics, complications, histopathological and multidisciplinary diagnosis was recorded. Logistic regression was used to analyze potential factors associated to diagnosis and complications. A total of 52 subjects were included. Mean number of samples was 5.7 (SD 1.7) with a median sample diameter of 6 mm (interquartile range 6-8). Pneumothorax developed in 13 (25%) participants, and no cases of severe bleeding or death were registered. A 73.1% and 84.5% diagnostic yield was recorded through histology and added multidisciplinary evaluation respectively. The number of samples was associated to the diagnostic yield in a multivariate analysis (OR 2.15 - CI95% 1.16- 3.99). TBLC appears to be safe and effective for the assessment of interstitial lung diseases in a real life setting when applied in a center with access to multidisciplinary evaluation.
