title: Transbronchial biopsy using endobronchial ultrasonography with a guide sheath increased the diagnostic yield of peripheral pulmonary lesions.
abstract: OBJECTIVE
  The advantage of transbronchial biopsy (TBB) using endobronchial ultrasonography (EBUS) with a guide sheath (GS) over TBB without EBUS guidance was investigated in this study.
  
  
  METHODS
  A retrospective chart review was conducted at Nagasaki University Hospital, Japan. Data were collected from all cases of peripheral pulmonary lesions (PPLs) undergoing either EBUS-GS-guided TBB or TBB without EBUS guidance in our department from December 2003 through November 2009. The diagnostic yield in each group was compared, after adjustment for other factors.
  
  
  RESULTS
  In total 110 PPLs were investigated in 102 patients: 65 (59.1%) were examined with EBUS-GS-guided TBB (EBUS-GS group) and 45 (40.9%) were TBB without EBUS guidance (non-EBUS group). Both procedures were performed under x-ray fluoroscopy. Basic characteristics were similar between the two groups. Of all EBUS examined lesions, 53 (81.5%) were visualized by EBUS. The diagnostic yields in EBUS-GS group and non-EBUS group were 64.6% and 46.7%, respectively (p=0.08). Adjusting for size and location of lesions, the yield of EBUS-GS guidance was 1.46 (95% confidence interval 1.03 to 2.05) times higher than without EBUS guidance. When the lesion was visualized by EBUS, the diagnostic yield ratio was further increased to 1.63 (95% CI 1.16 to 2.27).
  
  
  CONCLUSIONS
  EBUS-GS-guided TBB demonstrates a higher diagnostic yield than TBB without EBUS guidance.
authors.affiliation: Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ishida
authors.forename: Motoi
authors.initials: M
authors.lastname: Suzuki
authors.forename: Akitsugu
authors.initials: A
authors.lastname: Furumoto
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Tsuchihashi
authors.forename: Koya
authors.initials: K
authors.lastname: Ariyoshi
authors.forename: Konosuke
authors.initials: K
authors.lastname: Morimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000295:instrumentation / Q000379:methods*; D001999:Bronchoscopy / Q000295:instrumentation / Q000379:methods; D019160:Endosonography / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods*