Analysis of indications for pulmonary peripheral lesions diagnosed using radial endobronchial ultrasound‑guided transbronchial lung biopsy

Guan,Shu‑Hong; Zhang,Ming; Zhang,Su‑Juan; Zhang,Qiu‑Di; Xu,Qian‑Qian; Zhou,Jun

doi:10.3892/etm.2020.8734

Analysis of indications for pulmonary peripheral lesions diagnosed using radial endobronchial ultrasound‑guided transbronchial lung biopsy

Authors:
- Shu‑Hong Guan
- Ming Zhang
- Su‑Juan Zhang
- Qiu‑Di Zhang
- Qian‑Qian Xu
- Jun Zhou
View Affiliations

Affiliations: Department of Respiratory and Critical Care Medicine, Changzhou No. 1 Hospital, Changzhou, Jiangsu 213000, P.R. China
Published online on: May 12, 2020 https://doi.org/10.3892/etm.2020.8734
Pages: 810-817
Copyright: © Guan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present study was to determine the indications for radial endobronchial ultrasound‑guided transbronchial lung biopsy (rEBUS‑D‑TBLB) for the diagnosis of peripheral pulmonary lesions (PPL) located at the bronchopulmonary segments and subsegments. Data collected from 774 patients who underwent rEBUS‑D‑TBLB for suspected PPL, including clinical information, distribution of lesions, diagnostic spectrum and diagnostic rate, were collected and retrospectively reviewed. Additionally, the Wilcoxon signed‑rank test was performed to analyze the diagnostic yield of lesions in bronchopulmonary subsegments under the lesion diameter limit of 3 cm. In total, 802 lesions were found in 774 patients. The diagnostic yield of rEBUS‑D‑TBLB for all lesions was 67.18%. Overall, 362 cases of malignant disease and 158 cases of benign disease were diagnosed, with sensitivities of 70.98 and 79.00% respectively. Lesions were distributed throughout the 18 bronchopulmonary segments of the lungs. The bronchopulmonary segments with >5% of the majority of the discovered lesions were LB1+2, LB3, LB6, LB10, RB1‑4 and RB9. The diagnostic yield of rEBUS‑D‑TBLB was found to be >65% for lesions located at LB3, RB1‑3 and RB9. Further rEBUS‑D‑TBLB examinations of the LB1+2a, LB6a and RB4b segments produced diagnostic yields of 81.25, 66.67 and 71.43% respectively. Finally, at segment RB4a, rEBUS‑D‑TBLB examination was more effective for lesions with diameters >3 cm compared with lesions with diameters <3 cm. The diagnostic yields for PPL distributed at LB1+2a, LB3, LB6a, RB1‑3, RB4a (diameter >3 cm), RB4b, and RB9 using rEBUS‑D‑TBLB were higher compared with for other segments, providing a theoretical basis for the clinical application of rEBUS‑D‑TBLB for the diagnosis of PPL in patients.

View Figures

View References

1	Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ and He J: Cancer statistics in China, 2015. CA Cancer J Clin. 66:115–132. 2016.PubMed/NCBI View Article : Google Scholar
2	Zheng R, Zeng H, Zhang S and Chen W: Estimates of cancer incidence and mortality in China, 2013. Chin J Cancer. 36(66)2017.PubMed/NCBI View Article : Google Scholar
3	Wong MCS, Lao XQ, Ho KF, Goggins WB and Tse SLA: Incidence and mortality of lung cancer: Global trends and association with socioeconomic status. Sci Rep. 7(14300)2017.PubMed/NCBI View Article : Google Scholar
4	Zeng H, Zheng R, Guo Y, Zhang S, Zou X, Wang N, Zhang L, Tang J, Chen J, Wei K, et al: Cancer survival in China, 2003-2005: A population-based study. Int J Cancer. 136:1921–1930. 2015.PubMed/NCBI View Article : Google Scholar
5	Wang T, Luo L and Zhou Q: Risk of pleural recurrence in early stage lung cancer patients after percutaneous transthoracic needle biopsy: A meta-analysis. Sci Rep. 7(42762)2017.PubMed/NCBI View Article : Google Scholar
6	Luo K, Lin Y, Lin X, Yu X, Wen J, Xi K, Lin P and Zhang L: Localization of peripheral pulmonary lesions to aid surgical resection: A novel approach for electromagnetic navigation bronchoscopic dye marking. Eur J Cardiothorac Surg. 52:516–521. 2017.PubMed/NCBI View Article : Google Scholar
7	Han Y, Kim HJ, Kong KA, Kim SJ, Lee SH, Ryu YJ, Lee JH, Kim Y, Shim SS and Chang JH: Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis. PLoS One. 13(e0191590)2018.PubMed/NCBI View Article : Google Scholar
8	Durakovic A, Andersen H, Christiansen A and Hammen I: Retrospective analysis of radial EBUS outcome for the diagnosis of peripheral pulmonary lesion: Sensitivity and complications. Eur Clin Respir J. 2(28947)2015.PubMed/NCBI View Article : Google Scholar
9	Kurimoto N, Miyazawa T, Okimasa S, Maeda A, Oiwa H, Miyazu Y and Murayama M: Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically. Chest. 126:959–965. 2004.PubMed/NCBI View Article : Google Scholar
10	Liu J, Han J, Lv H and Li B: An ultrasonic sensor system based on a two-dimensional state method for highway vehicle violation detection applications. Sensors (Basel). 15:9000–9021. 2015.PubMed/NCBI View Article : Google Scholar
11	Park J, Je Y, Lee H and Moon W: Design of an ultrasonic sensor for measuring distance and detecting obstacles. Ultrasonics. 50:340–346. 2010.PubMed/NCBI View Article : Google Scholar
12	Paradis TJ, Dixon J and Tieu BH: The role of bronchoscopy in the diagnosis of airway disease. J Thorac Dis. 8:3826–3837. 2016.PubMed/NCBI View Article : Google Scholar
13	Durheim MT, Kim S, Gulack BC, Burfeind WR, Gaissert HA, Kosinski AS and Hartwig MG: Mortality and respiratory failure after thoracoscopic lung biopsy for interstitial lung disease. Ann Thorac Surg. 104:465–470. 2017.PubMed/NCBI View Article : Google Scholar
14	Lieberman S, Gleason JB, Ilyas MIM, Martinez F, Mehta JP and Savage EB: Assessing the safety and clinical impact of thoracoscopic lung biopsy in patients with interstitial lung disease. J Clin Diagn Res. 11:OC57–OC59. 2017.PubMed/NCBI View Article : Google Scholar
15	Jo Y, Han DH, Beck KS, Park JS and Kim TJ: Practice pattern of transthoracic needle biopsy: 2016 survey in the members of Korean society of thoracic radiology. Korean J Radiol. 18:1005–1011. 2017.PubMed/NCBI View Article : Google Scholar
16	Anzidei M, Porfiri A, Andrani F, Di Martino M, Saba L, Catalano C and Bezzi M: Imaging-guided chest biopsies: Techniques and clinical results. Insights Imaging. 8:419–428. 2017.PubMed/NCBI View Article : Google Scholar
17	Heerink WJ, de Bock GH, de Jonge GJ, Groen HJ, Vliegenthart R and Oudkerk M: Complication rates of CT-guided transthoracic lung biopsy: Meta-analysis. Eur Radiol. 27:138–148. 2017.PubMed/NCBI View Article : Google Scholar
18	Accordino MK, Wright JD, Buono D, Neugut AI and Hershman DL: Trends in use and safety of image-guided transthoracic needle biopsies in patients with cancer. J Oncol Pract. 11:e351–e359. 2015.PubMed/NCBI View Article : Google Scholar
19	Kim EJ and Kim KC: Utility of radial probe endobronchial ultrasound-guided transbronchial lung biopsy in diffuse lung lesions. Tuberc Respir Dis (Seoul). 82:201–210. 2019.PubMed/NCBI View Article : Google Scholar
20	Zhan P, Zhu QQ, Miu YY, Liu YF, Wang XX, Zhou ZJ, Jin JJ and Li Q: Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: A systematic review and meta-analysis. Transl Lung Cancer Res. 6:23–34. 2017.PubMed/NCBI View Article : Google Scholar
21	Dhooria S, Sehgal IS, Gupta N, Aggarwal AN, Behera D and Agarwal R: Role of radial endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of pulmonary nodules: Case report and literature review. Lung India. 34:61–64. 2017.PubMed/NCBI View Article : Google Scholar
22	Steinfort DP, Khor YH, Manser RL and Irving LB: Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: Systematic review and meta-analysis. Eur Respir J. 37:902–910. 2011.PubMed/NCBI View Article : Google Scholar
23	Hayama M, Izumo T, Chavez C, Matsumoto Y, Tsuchida T and Sasada S: Additional transbronchial needle aspiration through a guide sheath for peripheral pulmonary lesions that cannot be detected by radial EBUS. Clin Respir J. 11:757–764. 2017.PubMed/NCBI View Article : Google Scholar
24	Boonsarngsuk V, Kanoksil W and Laungdamerongchai S: Diagnosis of peripheral pulmonary lesions with radial probe endobronchial ultrasound-guided bronchoscopy. Arch Bronconeumol. 50:379–383. 2014.(In English, Spanish). PubMed/NCBI View Article : Google Scholar
25	Zhang Q, Zhang S, Xu X, Xu Q and Zhou J: Value of radial probe endobronchial ultrasound-guided transbronchial biopsy and computer tomography-guided transthoracic needle aspiration in the diagnosis of peripheral pulmonary lesions. Medicine (Baltimore). 96(e7843)2017.PubMed/NCBI View Article : Google Scholar
26	Zhang S, Zhou J, Zhang Q, Xu Q and Xu X: Diagnosis of peripheral lung diseases by combined measurement with ultrasound guidance under bronchoscope. Chin J Tuberc Respir. 38:566–569. 2015.(In Chinese).
27	Fukusumi M, Ichinose Y, Arimoto Y, Takeoka S, Homma C, Matsuoka H, Mouri A, Hamamoto Y, Matsumoto J and Kamimura M: Bronchoscopy for pulmonary peripheral lesions with virtual fluoroscopic preprocedural planning combined with EBUS-GS: A pilot study. J Bronchology Interv Pulmonol. 23:92–97. 2016.PubMed/NCBI View Article : Google Scholar
28	Hsia DW, Jensen KW, Curran-Everett D and Musani AI: Diagnosis of lung nodules with peripheral/radial endobronchial ultrasound-guided transbronchial biopsy. J Bronchology Interv Pulmonol. 19:5–11. 2012.PubMed/NCBI View Article : Google Scholar
29	Eberhardt R, Anantham D, Ernst A, Feller-Kopman D and Herth F: Multimodality bronchoscopic diagnosis of peripheral lung lesions: A randomized controlled trial. Am J Respir Crit Care Med. 176:36–41. 2007.PubMed/NCBI View Article : Google Scholar