Endobronchial Ultrasound Using Guide Sheath-Guided Transbronchial Lung Biopsy in Ground-Glass Opacity Pulmonary Lesions without Fluoroscopic Guidance
Author:
Park Jongsoo1ORCID, Kim Changwoon2, Jang Jong Geol2, Lee Seok Soo3, Hong Kyung Soo2, Ahn June Hong2ORCID
Affiliation:
1. Department of Radiology, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea 2. Division of Pulmonology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea 3. Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea
Abstract
Diagnosing ground-glass opacity (GGO) pulmonary lesions poses challenges. This study evaluates the utility of radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) in diagnosing GGO pulmonary lesions. A total of 1651 RP-EBUS procedures were performed during the study period. This study analyzed 115 GGO lesions. The EBUS visualization yield was 80.1%. Of 115 lesions, 69 (60%) were successfully diagnosed. The average size of diagnosed lesions was significantly larger than that of undiagnosed lesions (21.9 ± 7.3 vs. 17.1 ± 6.6 mm, p < 0.001). Diagnostic yield varied by lesion size: 50.0% for lesions <20 mm, 65.1% for 20–30 mm lesions, and 85.7% for lesions >30 mm. The mixed blizzard sign on EBUS appeared in 60.6% of mixed GGO lesions, with no cases in pure GGO lesions. Multivariable analyses showed that lesion size (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.00–1.16; p < 0.001) and mixed blizzard sign on EBUS (OR, 20.92; CI, 7.50–58.31; p < 0.001) were significantly associated with diagnostic success. Pneumothorax and hemoptysis occurred in 1.7% and 2.6% of patients, respectively. RP-EBUS-TBLB without fluoroscopic guidance is a viable diagnostic approach for GGO pulmonary lesions with acceptable complications.
Funder
2022 Yeungnam University Research Grant
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