Improvements to diagnosis peripheral lung lesions with a hand- drawn bronchial map: a cohort study

Abstract

Peripheral lung lesions (PLLs) have become common findings in routine medical practice. To evaluate whether the hand-drawn bronchial map (HBM) can increase the diagnostic yield of bronchoscope for PLLs. A study on the evaluation of this method for the diagnosis of PPLs was conducted on patients from January 2020 to December 2020 in the Department of Respiratory Medicine, Zhejiang Provincial People’s Hospital. Patients who underwent transbronchial lung biopsy (TBLB) with HBM were included in the HBM group and enrolled into the NHBM group without HBM. A total of 105 patients were included. 71 patients were in the HBM group and 34 patients were in the NHBM group. Overall, 61 (61.62%) of the confirmed lesions were malignant and adenocarcinoma was the main type. 38 (38.38%) lesions were benign. The overall determined diagnostic yield of benign lesions and malignant lesions was no significant difference (P = 0.101). When lesion > 20 mm and ≤ 30 mm, the diagnostic yield in HBM group was significantly higher than that in NHBM group (80.77% vs 45.45%, p=0.032). Compared to the NHBM group, endobronchial ultrasound (EBUS) detection rate in the HBM group had significantly higher diagnostic yield (83.1% vs 58.82%, p=0.007). Multivariate analysis showed that only lesion > 2cm and the bronchial generation of lesion ≤ 5th generation affected diagnostic yield. A hand-drawn bronchial map with high convenience and low cost greatly increases EBUS detection rate and diagnostic yield of bronchoscope for PPLs.