PURPOSE:The aim of this study was to evaluate the diagnostic utility of endobronchial ultrasound (EBUS)-guided transbronchial biopsy (TBB) using a novel 3.4-mm thin bronchoscope and a 1.4-mm EBUS probe for peripheral pulmonary lesions.
METHODS:A total of 86 patients with suspected peripheral lesions were included in this prospective study. After informed consent was obtained, EBUS-TBBs were performed using a prototype 3.4-mm thin bronchoscope (XBF-3B260Y1; Olympus) and a 1.4-mm radial ultrasonic probe (XUM-S20–17R; Olympus) under fluoroscopic guidance. Peripheral lesions were defined as the lesions located beyond the segmental bronchi.
RESULTS:Twelve patients with endobronchial lesions within the segmental bronchi that were defined as central lesions and 3 patients who did not return to follow-up were excluded from this analysis. Thus, a total of 71 patients (45 men and 26 women; mean age, 67.2 years) with peripheral pulmonary lesions (mean size, 31.2 ± 12.7 mm; range, 8 to 70 mm) were included in the final analysis. The mean bronchus level reached with the thin bronchoscope was 4.6th generation bronchi. Diagnostic histologic specimen was obtained in 49 of 71 patients (69%: 52% for benign lesions and 80% for malignant lesions). A definitive diagnosis of malignancy for lesions ≥ 20 mm and lesions < 20 mm was made in 82% (31 of 38) and 67% (4 of 6), respectively. There were no major complications.
CONCLUSION:EBUS-TBB using a 3.4-mm thin bronchoscope and a 1.4-mm radial probe is accurate and safe for the diagnosis of peripheral pulmonary lesions.
CLINICAL IMPLICATIONS:This procedure may be a useful alternative to conventional bronchoscopy for examining peripheral pulmonary lesions.
DISCLOSURE:Masahide Oki, No Financial Disclosure Information; No Product/Research Disclosure Information