Multivariate study of predictive factors for clearly defined lung lesions without visible endobronchial lesions in transbronchial biopsy

Botana-Rial, Maribel; Núñez-Delgado, Manuel; Pallarés-Sanmartín, Abel; Leiro-Fernández, Virginia; Torres-Durán, María; Represas-Represas, Cristina; Fernández-Villar, Alberto

doi:10.1007/s00464-010-1080-4

Cited by 11 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…lesions not endobronchially visible) may be ,20% [5,6]. Diagnostic yield is improved by the use of fluoroscopic guidance during performance of transbronchial lung biopsies (TBLB) [6,7], although it varies considerably across studies from ,45% [6,8,9] to .70% [10,11]. The highest diagnostic yield for bronchoscopic evaluation of PPLs appears to be associated with use of radial probe endobronchial ultrasound (EBUS).…”

mentioning

confidence: 99%

Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis

Steinfort¹,

Khor²,

Manser³

et al. 2010

Eur Respir J

373

309

View full text Add to dashboard Cite

Improved diagnostic sensitivity of bronchsocopy for the investigation of peripheral pulmonary lesions (PPLs) with the use of radial probe endobroncial ultrasound (EBUS) has been reported, although diagnostic performance varies considerably.A systematic review of published literature evaluating radial probe EBUS accuracy was performed to determine point sensitivity and specificity, and to construct a summary receiveroperating characteristic curve. Sub-group analysis and linear regression was used to identify possible sources of study heterogeneity.16 studies with 1,420 patients fulfilled inclusion criteria. Significant inter-study variation in EBUS method was noted. EBUS had point specificity of 1.00 (95% CI 0.99-1.00) and point sensitivity of 0.73 (95% CI 0.70-0.76) for the detection of lung cancer, with a positive likelihood ratio of 26.84 (12.60-57.20) and a negative likelihood ratio of 0.28 (0.23-0.36). Significant interstudy heterogeneity for sensitivity was observed, with prevalence of malignancy, lesion size and reference standard used being possible sources.EBUS is a safe and relatively accurate tool in the investigation of PPLs. Diagnostic sensitivity of EBUS may be influenced by the prevalence of malignancy in the patient cohort being examined and lesion size. Further methodologically rigorous studies on well-defined patient populations are required to evaluate the generalisability of our results.

show abstract

mentioning

confidence: 99%

Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis

Steinfort¹,

Khor²,

Manser³

et al. 2010

Eur Respir J

373

309

View full text Add to dashboard Cite

show abstract

“…Many researchers have sought to determine factors that improve the diagnostic yield of bronchoscopy. Several factors that affect the diagnostic yield of conventional bronchoscopy in patients with peripheral lung lesions without endobronchial lesions have been suggested: the CT bronchus sign, size of the lesion, etiology of the lesion, and location of the lesion1617181920. A point that claims our attention is that most of the studies routinely used fluoroscopy as guidance to increase the sensitivity of bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic yield from TBLB for benign lesions is generally known to be lower than that for malignant lesions172627. However, these studies used results from fluoroscopy-guided bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

Factors Related to the Diagnostic Yield of Flexible Bronchoscopy without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Kang

et al. 2017

Tuberc Respir Dis

View full text Add to dashboard Cite

BackgroundWe aimed to analyze the factors predicting the diagnostic performance of flexible bronchoscopy without guidance in peripheral lung lesions that are endoscopically invisible.MethodsThis was a retrospective study conducted in St. Paul's Hospital, The Catholic University of Korea, between January 2007 and March 2013. We included all patients who received bronchoscopy during this period. The analyzed variables were age, sex, the etiology of the lesion, lesion size, distance from the pleura, and presence of the bronchus sign. We used multiple logistic regression analysis to identify the significant independent factors associated with diagnostic yield.ResultsWe included 151 patients in this study. The overall diagnostic yield was 58.3%. The sensitivity was 43.2% for malignant disease and 78.1% for benign disease. The benign lung lesions (p<0.001), lesion size (p=0.015), presence of the exposed type of bronchus sign (p<0.001), and presence of cavitary lung lesions (p=0.005) were factors influencing the yield of flexible bronchoscopy by univariate analysis. In a multivariate logistic regression analysis, the exposed type of bronchus sign and benign lung lesions were independent predicting factors (odds ratio [OR]: 27.95; 95% confidence interval [CI], 7.56–103.32; p<0.001 and OR, 4.91; 95% CI, 1.76–13.72; p=0.002).ConclusionThe presence of the exposed type of bronchus sign and benign lung lesions are determining factors of the diagnostic yield in flexible bronchoscopy in evaluating peripheral lesions that are not endoscopically visible.

show abstract

“…Traditional flexible bronchoscopy with TBLB has a low diagnostic yield in these patients. For the lung nodules <2 cm, the data from ten studies shows the average diagnostic yield of FOB to vary from 11 to 76 % with an average of 34 %, [46] On multivariate analysis, the independent predictors of obtaining diagnostic tissue sample from lung nodules with flexible bronchoscopy in a study were malignant etiology, and a positive bronchus sign, again reinforcing the importance of size and bronchus sign as important determinants of diagnostic yield of conventional bronchoscopy in these patients, [47]. There are several problems with the use of CTfluoroscopy with conventional bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

Exobronchial Pulmonary Eye: Transthoracic Ultrasound-Guided Transbronchial Lung Biopsy in Different Pulmonary Shadows

Abumossalam¹

2015

IJMI

View full text Add to dashboard Cite

Abstract:Background: Transbronchial lung biopsy (TBLB) is one of the most imperative applications of flexible bronchoscopy that may preclude the need for an open lung biopsy. A real-time ultrasonographic guidance may increase the diagnostic yield of TBLB. Purpose: The aim of this study is to evaluate the diagnostic yield of a real-time transthoracic ultrasound-guided transbronchial lung biopsy (TTUS-TBLB) in different pulmonary shadows. Patients and methods: One hundred and seventeen patients with radiological pulmonary shadows were submitted for fiberoptic bronchscopy and underwent either conventional TBLB (cTBLB) that only supported by prior localization with chest computed tomography (CT) in 84 patients (group 1) or under a real-time TTUS-TBLB in 33 patients (group 2). Results: The overall diagnostic yield of TBLB was 74.4% (87 cases out of 117; 79 cases by the first TBLB and 8 cases by second TBLB). The final diagnosis of the enrolled patients was; fifty two cases proved to be malignant (42 cases diagnosed by TBLB) and sixty five cases proved to be nonmalignant (45 cases diagnosed by TBLB). TTUS-TBLB achieved diagnosis in 81.81% of cases and cTBLB achieved diagnosis in 71.43%. Conclusion: The results of real-time TTUS-TBLB were promising and may improve the overall diagnostic yield of TBLB in either benign or malignant pulmonary shadows.

show abstract

Multivariate study of predictive factors for clearly defined lung lesions without visible endobronchial lesions in transbronchial biopsy

Abstract: TBB of lesions clearly delimited without an endobronchial lesion can lead to diagnosis in almost half of the patients. The nature of the lesion, diameter >20 mm, and the presence of the bronchus sign are independent predictors of outcome.

Cited by 11 publications

References 20 publications

Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis

Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis

Factors Related to the Diagnostic Yield of Flexible Bronchoscopy without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Exobronchial Pulmonary Eye: Transthoracic Ultrasound-Guided Transbronchial Lung Biopsy in Different Pulmonary Shadows

Contact Info

Product

Resources

About