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A Randomized Controlled Trial on Optimal Sampling Sequence in Radial Guide Sheath Endobronchial Ultrasound Lung Biopsy.
- Source :
-
Journal of bronchology & interventional pulmonology [J Bronchology Interv Pulmonol] 2020 Jul; Vol. 27 (3), pp. 205-211. - Publication Year :
- 2020
-
Abstract
- Background: An optimal sampling sequence in radial guide sheath endobronchial ultrasound lung biopsy (R-EBUS) is unclear. This prospective single-center pilot randomized controlled trial aimed to determine if the initial method and sequence of sampling affect the diagnostic accuracy of the procedure.<br />Methods: Consecutive patients undergoing R-EBUS for lesions >15 mm with a bronchus sign were randomly assigned (1:1:1) to biopsy first (group A), brushings first (group B) or combination (group C). The primary outcome was a positive diagnosis from any sampling method.<br />Results: Fifty-four patients were randomized. The overall diagnostic yield of the procedure was 77.8% (95% confidence interval: 66%-89%), with no difference between groups. A higher rate of positive cytology from brushings was seen if the biopsies were performed before brushings (77.8% in group A vs. 44.4% in group B, P=0.03). The rate of positive cytology from washings was higher if the washings were obtained just after the brushings (61.1% in group A vs. 11.1% in group B, P=0.02). There was no difference in the rate of positive biopsy histology in the groups (P=0.27). All 3 sampling modalities were more likely to be positive in group A (50.0% vs. 11.1% in group B and 22.2% in group C, P=0.04). Complications rate was low and not significantly different between groups.<br />Conclusion: The overall rate of a positive R-EBUS procedure was not affected by the initial sampling method or sequence. However, all 3 sampling modalities were more likely to be positive if biopsies were performed first, followed by brushings and washings.
- Subjects :
- Aged
Aged, 80 and over
Bronchi pathology
Bronchoscopy methods
Case-Control Studies
Endosonography instrumentation
Female
Histological Techniques statistics & numerical data
Humans
Image-Guided Biopsy methods
Lung Neoplasms diagnosis
Male
Middle Aged
Prospective Studies
Tomography, X-Ray Computed methods
Biopsy instrumentation
Endosonography methods
Lung pathology
Lung Neoplasms pathology
Specimen Handling methods
Subjects
Details
- Language :
- English
- ISSN :
- 1948-8270
- Volume :
- 27
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of bronchology & interventional pulmonology
- Publication Type :
- Academic Journal
- Accession number :
- 32101915
- Full Text :
- https://doi.org/10.1097/LBR.0000000000000651