Ribeiro Neto ML, Arrossi AV, Yadav R, Culver DA, Mukhopadhyay S, Parambil JG, Southern BD, Tolle L, Pande A, Almeida FA, Sahoo D, Glennie J, Ahmad U, Mehta AC, Gildea TR. Prospective cohort of cryobiopsy in interstitial lung diseases: a single center experience.
BMC Pulm Med 2022;
22:215. [PMID:
35655191 PMCID:
PMC9161499 DOI:
10.1186/s12890-022-01990-4]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
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%.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12890-022-01990-4.
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