Improved diagnostic yield of bronchoscopy in peripheral pulmonary lesions: combination of radial probe endobronchial ultrasound and rapid on-site evaluation.

Chia-Hung Chen Wen-Chien Cheng Biing-Ru Wu Chih-Yu Chen Wei-Chun Chen Te-Chun Hsia Wei-Chih Liao Chih-Yen Tu Chuen-Ming Shih Wu-Huei Hsu Ko-Pen Wang

J Thorac Dis

1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan ; 2 Department of Respiratory Therapy, 3 Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan ; 4 School of Medicine, China Medical University, Taichung, Taiwan ; 5 Department of Internal Medicine, Hyperbaric oxygen therapy center, China Medical University, Taichung, Taiwan ; 6 Department of Life Science, National Chung Hsing University, Taichung, Taiwan ; 7 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, School of Medicine Baltimore, Maryland, USA.

Published: December 2015

Rapid on-site evaluation (ROSE) enhances the diagnostic accuracy of radial probe endobronchial ultrasound (R-EBUS) for diagnosing peripheral pulmonary lesions (PPLs) during needle aspiration.
A study analyzed data from 815 patients and found that ROSE increased diagnostic yields, particularly in challenging cases, with a success rate of 76.9% through R-EBUS-guided procedures.
The results suggest that integrating ROSE with R-EBUS can significantly benefit the diagnosis of PPLs, particularly in small lesions or those with specific anatomical challenges.

Background: Rapid on-site evaluation (ROSE) of cytologic specimens is a useful ancillary technique in needle aspiration procedures of pulmonary/mediastinal lesions, but few reports had been carried out to confirm the utility in the diagnosis of peripheral pulmonary lesions (PPLs) by radial probe endobronchial ultrasound (R-EBUS).

Methods: To evaluate the impact of ROSE on the diagnostic yield of R-EBUS for PPLs, we retrospectively analyzed the diagnostic yields of transbronchial biopsy (TBB) or brushing using R-EBUS for patients with PPLs in a tertiary university hospital from December 2012 to December 2014.

Results: A total of 815 patients with PPLs were included. A definite diagnosis was made by R-EBUS-guided TBB or brushing for 627 patients (76.9%). A total of 279 patients (34.2%) were examined by a ROSE technique. The combination of R-EBUS guided TBB or brushing with ROSE raised the diagnostic yield in the diagnosis of PPLs, especially difficult cases: right apical and left apical-posterior segment locations, small PPLs <3 cm without bronchus signs on computed tomography (CT) scan, PPLs with pleural effusions, and the position of probe is not within.

Conclusions: ROSE can improve the PPLs diagnostic yield when using R-EBUS guided TBB or brushing.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700367	PMC
http://dx.doi.org/10.3978/j.issn.2072-1439.2015.12.13	DOI Listing

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