title: Transbronchial Catheter Aspiration and Transbronchial Needle Aspiration in the Diagnostic Workup of Peripheral Lung Lesions.
abstract: OBJECTIVE
  Increasingly frequent, it is clinically indicated to obtain tissue from a peripheral lung lesion (PLL) to yield a pathological diagnosis. The aim of the present study was to evaluate the diagnostic sensitivity of transbronchial needle aspiration (TBNA) and transbronchial catheter aspiration (TBCA) in addition to transbronchial forceps biopsy (TBB) at conventional bronchoscopy.
  
  
  METHODS
  Eligible patients showing a PLL on computed tomography scans were included in the study. In all patients, following TBB, TBNA and TBCA were employed in randomised order under fluoroscopy.
  
  
  RESULTS
  Fourty-eight patients were enrolled, of whom 46 patients with 46 PLLs were included in the analysis. The mean ± SD diameter of the PLL was 27.0 ± 13.3 mm. The overall sensitivity for all modalities was 69.6%; PLL ≤20 or >20 and ≤30 mm in diameter showed a sensitivity of 60.0 and 72.2%, respectively. For malignant PLL (n = 33), the combined sensitivity of TBNA + TBCA versus TBB was significantly higher (63.6 vs. 33.3%, p ≤ 0.05), and could not further be improved by TBB. For benign PLL, TBB was superior to TBNA + TBCA (76.9 vs. 38.5%).
  
  
  CONCLUSIONS
  TBB, TBNA and TBCA are complementary to one another. Combining the three techniques, even allows transbronchial specimen collection of PLL <3 cm in diameter at conventional bronchoscopy.
authors.affiliation: Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Chair of Internal Medicine I, Witten/Herdecke University, Ambrocker Weg 60, 58091, Hagen, Germany. karl-josef.franke@helios-kliniken.de.
authors.forename: Karl-Josef
authors.initials: KJ
authors.lastname: Franke
authors.affiliation: Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Chair of Internal Medicine I, Witten/Herdecke University, Ambrocker Weg 60, 58091, Hagen, Germany. melanie.hein@helios-kliniken.de.
authors.forename: Melanie
authors.initials: M
authors.lastname: Hein
authors.affiliation: Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Chair of Internal Medicine I, Witten/Herdecke University, Ambrocker Weg 60, 58091, Hagen, Germany. ulrike.domanski@helios-kliniken.de.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Domanski
authors.affiliation: Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Chair of Internal Medicine I, Witten/Herdecke University, Ambrocker Weg 60, 58091, Hagen, Germany. georg.nilius@helios-kliniken.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Nilius
authors.affiliation: Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Chair of Internal Medicine I, Witten/Herdecke University, Ambrocker Weg 60, 58091, Hagen, Germany. maik.schroeder@helios-kliniken.de.
authors.forename: Maik
authors.initials: M
authors.lastname: Schroeder
authors.affiliation: Institute of Pathology, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany. jeremias.wohlschlaeger@uk-essen.de.|Institute of Pathology, Diakonissenkrankenhaus, Knuthstraße 1, 24939, Flensburg, Germany. jeremias.wohlschlaeger@uk-essen.de.
authors.forename: Jeremias
authors.initials: J
authors.lastname: Wohlschlaeger
authors.affiliation: Institute of Pathology, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany. dirk.theegarten@uk-essen.de.
authors.forename: Dirk
authors.initials: D
authors.lastname: Theegarten
mesh_terms: D001707:Biopsy, Needle / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology*; D057785:Catheters; D005260:Female; D005471:Fluoroscopy; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D061646:Operative Time; D011030:Pneumothorax / Q000209:etiology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D047368:Tumor Burden
keywords: Bronchoscopy; Lung cancer; Peripheral lung lesion; Transbronchial catheter aspiration; Transbronchial forceps biopsy; Transbronchial needle aspiration