Endobronchial ultrasound-guided transbronchial biopsy using novel thin bronchoscope for diagnosis of peripheral pulmonary lesions.
BACKGROUND
The aim of this study was to evaluate the diagnostic utility of endobronchial ultrasound (EBUS)-guided transbronchial biopsy (TBB) using a novel 3.4-mm thin bronchoscope and a 1.4-mm ultrasonic probe for peripheral pulmonary lesions.


METHODS
A total of 86 patients with suspected peripheral lesions were included in this prospective study. EBUS-TBBs were performed using a prototype 3.4-mm thin bronchoscope and a 1.4-mm radial ultrasonic probe under fluoroscopic guidance.


RESULTS
Twelve patients with endobronchial lesions within the segmental bronchi and three patients who did not return to follow-up were excluded from this analysis. Thus, a total of 71 patients with peripheral pulmonary lesions (mean size, 31.2 +/- 12.7 mm) were included in the final analysis. The mean bronchus level reached with the thin bronchoscope was 4.6 generations. Diagnostic histologic specimens were obtained in 49 of 71 patients (69%:80% for malignant lesions and 52% for benign lesions). A definitive diagnosis of malignancy for lesions > or =20 mm and lesions < 20 mm was made in 82% (31 of 38) and 67% (four of six), respectively. There were no significant complications.


CONCLUSIONS
The EBUS-TBB using a 3.4-mm thin bronchoscope and a 1.4-mm radial probe is feasible, accurate, and safe for the diagnosis of peripheral pulmonary lesions.
Oki
Masahide
M
Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan. masahideo@aol.com
Saka
Hideo
H
Kitagawa
Chiyoe
C
Kogure
Yoshihito
Y
Mori
Kouki
K
Kajikawa
Shigehisa
S
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001999:Bronchoscopy; D018287:Carcinoma, Large Cell / Q000000981:diagnostic imaging / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055752:Small Cell Lung Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D015996:Survival Rate