title: Endobronchial ultrasonography with a guide sheath for pure or mixed ground-glass opacity lesions.
abstract: BACKGROUND
  Ground-glass opacity (GGO) lesions are difficult to diagnose by transbronchial biopsy (TBB).
  
  
  OBJECTIVE
  We attempted to diagnose solitary peripheral GGO predominant-type lesions by TBB using endobronchial ultrasonography with a guide sheath (EBUS-GS) under X-ray fluoroscopic guidance, and to evaluate several factors associated with diagnostic yield.
  
  
  METHODS
  The medical records of 67 patients with GGO predominant-type lesions who underwent TBB using EBUS-GS under X-ray fluoroscopic guidance were retrospectively reviewed.
  
  
  RESULTS
  Of the 67 lesions, 38 (57%) were successfully diagnosed by EBUS-GS (5/11 pure GGO lesions and 33/56 mixed GGO lesions). The diagnosable lesions were significantly larger than the nondiagnosable lesions (24 vs. 17 mm, respectively; p < 0.01). Regarding the diagnostic yield by signs on computed tomography, the lesions with a bronchus leading directly to a lesion had a significantly higher diagnostic yield than the others (p < 0.05). When GGO lesions were confirmed under X-ray fluoroscopic guidance, the diagnostic yield was 79% (vs. 40% in lesions not visible on X-ray fluoroscopy; p < 0.05).
  
  
  CONCLUSIONS
  EBUS-GS is a useful and valuable diagnostic modality, even for GGO predominant-type lesions located at the lung periphery.
authors.affiliation: First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ikezawa
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sukoh
authors.forename: Naofumi
authors.initials: N
authors.lastname: Shinagawa
authors.forename: Kosuke
authors.initials: K
authors.lastname: Nakano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Oizumi
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nishimura
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional; D055815:Young Adult