Echoic features as predictors of diagnostic yield of endobronchial ultrasound-guided transbronchial lung biopsy in peripheral pulmonary lesions.
The endobronchial ultrasound (EBUS) features of peripheral pulmonary lesions (PPLs) are associated with histopathologic presentation. Certain histologic and radiologic characteristics of peripheral pulmonary lesions affect the diagnostic yield of transbronchial lung biopsies (TBLB). This study aimed to assess the feasibility of EBUS echoic features as predictors of diagnostic yield of TBLB. Four hundred and eight patients with PPLs underwent TBLB. The yields of TBLB in lesions with characteristic EBUS features were compared with those without such features. The overall diagnostic yield of TBLB was 64.2%. Lesion diameter (≥3 cm vs. <3 cm; 69.1% vs. 58.5%, p < 0.05), location of the EBUS probe (within vs. adjacent to lesions; 73.2% vs. 46.3%, p < 0.01) and lesion echogenicity (heterogeneous vs. homogeneous; 76.7% vs. 52.0%, p < 0.01) were associated with higher TBLB yields. In malignant PPLs, the echoic features associated with higher TBLB yields were lesion diameter (≥3 cm vs. <3 cm; 74.4% vs. 62.5%, p < 0.05), location of the EBUS probe (within vs. adjacent to lesions; 78.7% vs. 47.4%, p < 0.01), echoic feature of the margin (noncontinuous vs. continuous; 77.0% vs. 62.4%, p < 0.01) and lesion echogenicity (heterogeneous vs. homogeneous; 77.7% vs. 53.9%, p < 0.01). EBUS probe location, echoic feature of the margin and lesion echogenicity were independent predictors according to the results of multivariate analysis. In conclusion, EBUS features are feasible predictors of diagnostic yield of TBLB in peripheral lung lesions.
Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan.
Chih-Hsi
CH
Kuo
Shu-Min
SM
Lin
Fu-Tsai
FT
Chung
Kang-Yun
KY
Lee
Yung-Lun
YL
Ni
Yu-Lun
YL
Lo
Hao-Cheng
HC
Chen
Han-Pin
HP
Kuo
D001706:Biopsy / Q000295:instrumentation / Q000379:methods*; D001999:Bronchoscopy; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D019160:Endosonography / Q000295:instrumentation*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D018084:Ultrasonography, Interventional / Q000295:instrumentation*