Ultrasound-Guided Transbronchial Cryobiopsy Study

Overview

This study evaluates the effectiveness and safety of ultrasound-guided transbronchial cryobiopsy for examining mediastinal and hilar lesions. It compares this method to the standard technique known as EBUS-TBNA.

Study Details

Patients in four Swiss centers who needed diagnostic bronchoscopy for specific lesions were included. The study focuses on:

Diagnostic yield
Safety of EBUS-guided cryobiopsy versus EBUS-TBNA

Methods Used

The study involved various tools for targeting lesions:

Electric needle knife (70.8%)
19 G needle (12.4%)
22 G needle (16.8%)

Freezing times for cryobiopsies ranged from 4-10 seconds.

Key Findings

A total of 137 patients participated, with a median follow-up of 89 days. The results showed:

Diagnostic yield: 56.2% for EBUS-TBNA vs. 91.2% for cryobiopsies (p<0.001)
Increased diagnostic yield for benign disorders (+28.5%) and rare tumors (+5.9%) with cryobiopsy
For lung cancer, cryobiopsy provided better immunohistochemistry results (88.9% vs. 40.7%)

Adverse events occurred in 23.4% of patients, including mild to moderate bleeding (10.2%), pneumonia (0.7%), and one case of pneumothorax. No deaths or infections were reported.

Conclusion

Cryobiopsy significantly improves diagnostic outcomes compared to EBUS-TBNA while maintaining a good safety profile.

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