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Transbronchial lung cryobiopsy for diagnosing interstitial lung disease: a cross-sectional, comparative study
Min Yu1,2, Xuefeng Xu3, Xiaoyan Xin4
1Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, 210008, Jiangsu, China.
Insights
Transbronchial lung cryobiopsy (TBLC) offers a higher diagnostic yield (85.0%) for interstitial lung disease (ILD) compared to transbronchial lung biopsy (TBLB). TBLC demonstrates an acceptable safety profile, making it a valuable tool for ILD diagnosis.
Area of Science:
- Pulmonology
- Interventional Pulmonology
- Diagnostic Procedures
Background:
- Interstitial lung disease (ILD) diagnosis often requires invasive procedures.
- Transbronchial lung cryobiopsy (TBLC) is an emerging technique for ILD diagnosis.
- Comparison with traditional transbronchial lung biopsy (TBLB) is crucial for clinical adoption.
Purpose of the Study:
- To evaluate the diagnostic accuracy of TBLC versus TBLB in patients with suspected ILD.
- To assess the safety and complication rates associated with TBLC and TBLB.
Main Methods:
- A cross-sectional, comparative study analyzed patients with suspected ILD undergoing TBLC or TBLB.
- Data from June 2018 to September 2022 included procedure details and multidisciplinary discussion (MDD) diagnoses.
- Diagnostic yield and complication rates were retrospectively evaluated for both techniques.
Main Results:
- TBLC achieved a diagnostic yield of 85.0%, significantly higher than TBLB's 63.1%.
- TBLC showed 13.4% moderate bleeding and 14.4% pneumothorax; no severe bleeding occurred.
- Bleeding complication rates were similar between TBLC and TBLB groups.
Conclusions:
- TBLC demonstrates superior diagnostic yield for ILD compared to TBLB.
- TBLC possesses an acceptable safety profile, supporting its clinical applicability.
- This technique enhances diagnostic algorithms for interstitial lung diseases.
Objectives:
Transbronchial lung cryobiopsy (TBLC) has been identified to be a new technique to diagnosis interstitial lung disease (ILD). The study was conducted to investigate the safety and the diagnostic accuracy of TBLC contrast with transbronchial lung biosy (TBLB) in patients with ILD.
Methods:
In a cross-sectional and comparative study, patients with suspected ILD who underwent TBLC or TBLB were evaluated from June 2018 to September 2022 in Nanjing drum tower hospital. TBLC and TBLB procedure details and clinical multidisciplinary discussion (MDD) diagnosis based on clinical, radiological, and histopathological information were retrospectively analyzed. Diagnostic yield and complications of TBLC and TBLB were evaluated.
Results:
187 patients who underwent TBLC and 176 patients who underwent TBLB following a standardized protocol were enrolled. The diagnostic yield of TBLC and TBLB in patients with ILD were 85.0% and 63.1%, respectively. In TBLC, 162 patients (86.6%) had no or mild bleeding and 25 patients (13.4%) had moderate bleeding. None of the patients had severe bleeding and the rate of pneumothorax was 14.4%. Comparatively, pooled incidences of complications were 91.5% for no or mild bleeding, 8.5% for moderate bleeding and 5.1% for pneumothorax after TBLB. There was no difference in the occurrence of bleeding among TBLC group and TBLB group.
Conclusions:
This study indicated that the clinical applicability of TBLC in ILD diagnostic algorithms, with a diagnostic yield of 85.0% and an acceptable safety profile.
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