Author:
Ribeiro Neto Manuel L.,Arrossi Andrea Valeria,Yadav Ruchi,Culver Daniel A.,Mukhopadhyay Sanjay,Parambil Joseph G.,Southern Brian D.,Tolle Leslie,Pande Aman,Almeida Francisco A.,Sahoo Debasis,Glennie Jessica,Ahmad Usman,Mehta Atul C.,Gildea Thomas R.
Abstract
Abstract
Rationale
Transbronchial cryobiopsy has been increasingly used to diagnose interstitial lung diseases. However, there is uncertainty regarding its accuracy and risks, mainly due to a paucity of prospective or randomized trials comparing cryobiopsy to surgical biopsy.
Objectives
To evaluate the diagnostic yield and complications of cryobiopsy in patients selected by multidisciplinary discussion.
Methods
This was a prospective cohort from 2017 to 2019. We included consecutive patients with suspected interstitial lung diseases being considered for lung biopsy presented at our multidisciplinary meeting.
Measurements and main results
Of 112 patients, we recommended no biopsy in 31, transbronchial forceps biopsy in 16, cryobiopsy in 54 and surgical biopsy in 11. By the end of the study, 34 patients had had cryobiopsy and 24 patients, surgical biopsy. Overall pathologic and multidisciplinary diagnostic yield of cryobiopsy was 47.1% and 61.8%, respectively. The yield increased over time for both pathologic (year 1: 28.6%, year 2: 54.5%, year 3: 66.7%, p = 0.161) and multidisciplinary (year 1: 50%, year 2: 63.6%, year 3: 77.8%, p = 0.412) diagnosis. Overall rate of grade 4 bleeding after cryobiopsy was 11.8%. Cryobiopsy required less chest tube placement (11.8% vs 100%, p < 0.001) and less hospitalizations compared to surgical biopsy (26.5% vs 95.7%, p < 0.001), but hospitalized patients had a longer median hospital stay (2 days vs 1 day, p = 0.004).
Conclusions
Diagnostic yield of cryobiopsy increased over time but the overall grade 4 bleeding rate was 11.8%.
Publisher
Springer Science and Business Media LLC
Subject
Pulmonary and Respiratory Medicine
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