title: Cryobiopsy in the diagnosis of diffuse interstitial lung disease: yield and cost-effectiveness analysis.
abstract: BACKGROUND
  Assessment of patients with suspected interstitial lung disease (ILD) includes surgical lung biopsy (SLB) when clinical and radiological data are inconclusive. However, cryobiopsy is acquiring an important role in the ILD diagnostic process. The objective of this study was to evaluate the diagnostic yield, safety and economic costs of the systematic use of cryobiopsy in the assessment of patients with suspected ILD.
  
  
  METHODS
  This was a retrospective observational study of patients who had undergone transbronchial cryobiopsy for evaluation of ILD from January 2011 to January 2014. The procedures were performed with a video bronchoscope using a cryoprobe for the collection of lung parenchyma specimens, which were analyzed by pathologists. Diagnostic yield, complications and economic costs of this technique were analyzed.
  
  
  RESULTS
  Criobiopsy specimens from a total of 33 patients were included. A specific diagnosis was obtained in 26, producing a diagnostic yield of 79%. In 5 patients, SLB was required for a histopathological confirmation of disease, but the procedure could not be performed in 4, due to severe comorbidities. The most frequent complications were pneumothorax (12%) and gradei (9%) or gradeii (21%) bleeding. There were no life-threatening complications. The systematic use of cryobiopsy saved up to €59,846.
  
  
  CONCLUSIONS
  Cryobiopsy is a safe and potentially useful technique in the diagnostic assessment of patients with ILD. Furthermore, the systematic use of cryobiopsy has an important economic impact.
authors.affiliation: Servicio de Neumología y Alergia Respiratoria, Institut del Tòrax, Hospital Clínic, Barcelona, España.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Hernández-González
authors.affiliation: Servicio de Neumología y Alergia Respiratoria, Institut del Tòrax, Hospital Clínic, Barcelona, España.
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Lucena
authors.affiliation: Servicio de Anatomía Patológica, Hospital Clínic, Barcelona, España.
authors.forename: José
authors.initials: J
authors.lastname: Ramírez
authors.affiliation: Servicio de Radiodiagnóstico, Hospital Clínic, Barcelona, España.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Sánchez
authors.affiliation: Servicio de Anestesia y Reanimación, Hospital Clínic, Barcelona, España.
authors.forename: María José
authors.initials: MJ
authors.lastname: Jimenez
authors.affiliation: Servicio de Neumología y Alergia Respiratoria, Institut del Tòrax, Hospital Clínic, Barcelona, España.
authors.forename: Antoni
authors.initials: A
authors.lastname: Xaubet
authors.affiliation: Servicio de Neumología y Alergia Respiratoria, Institut del Tòrax, Hospital Clínic, Barcelona, España. Electronic address: sellares@clinic.ub.es.
authors.forename: Jacobo
authors.initials: J
authors.lastname: Sellares
authors.affiliation: Servicio de Neumología y Alergia Respiratoria, Institut del Tòrax, Hospital Clínic, Barcelona, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Agustí
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001992:Bronchoalveolar Lavage Fluid; D001999:Bronchoscopy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D003452:Cryosurgery / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D017563:Lung Diseases, Interstitial / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D015641:Radiography, Interventional / Q000191:economics / Q000379:methods; D012189:Retrospective Studies; D020535:Video-Assisted Surgery / Q000009:adverse effects / Q000379:methods*
keywords: Biopsia pulmonar transbronquial; Criobiopsia; Cryobiopsy; Enfermedad pulmonar intersticial difusa; Interstitial lung disease; Transbronchial lung biopsy