title: Radial Endobronchial Ultrasound (EBUS) Guided Suction Catheter-Biopsy in Histological Diagnosis of Peripheral Pulmonary Lesions.
abstract: BACKGROUND
  EBUS guided trans-bronchial biopsy became routine in diagnosis of peripheral pulmonary lesions (PPL). Suction catheter-biopsy is a technique for obtaining a tissue sample from peripheral lung parenchyma. Aim of this study was to evaluate diagnostic efficiency, feasibility and safety of EBUS guided suction catheter-biopsy (SCB) in comparison to trans-bronchial biopsy (TBB) in diagnosis of PPL. The main intention was to demonstrate non-inferiority of the technique over trans-bronchial biopsy, especially when used under navigation of the EBUS.
  
  
  METHODS
  Radial EBUS probe (UM-3R, Olympus Co, Japan.) without guiding sheath was used to navigate suction catheter and TBB forceps to the PPL. The catheter was connected to the collection canister via vacuum pump. The SCB specimens were fixed with 10% buffered formalin.
  
  
  RESULTS
  There were 168 patients enrolled in this study; 69.9% males and 30.1% females. Main lesion diameter was 4.1±1.9 cm. Majority of patients, 131(77.9%) were diagnosed with lung cancer. Per-biopsy calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for EBUS-SCB were 92.4%, 100%, 100% and 67.7%, respectively. Corresponding values for EBUS-TBB were 92.3%, 100%, 100% and 69.7%. Only the size of the lesion significantly influenced (p=0.005) diagnostic performance. Complications occurred in 2 patients; one pneumothorax and one excessive bleeding.
  
  
  CONCLUSIONS
  EBUS guided SCB is efficient, feasible and safe in diagnosis of peripheral lung cancer. The technique is complementary to trans-bronchial biopsy.
authors.affiliation: 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia.
authors.forename: Bojan
authors.initials: B
authors.lastname: Zaric
authors.affiliation: 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Stojsic
authors.affiliation: 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Carapic
authors.affiliation: 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia.
authors.forename: Tomi
authors.initials: T
authors.lastname: Kovacevic
authors.affiliation: 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia.
authors.forename: Goran
authors.initials: G
authors.lastname: Stojanovic
authors.affiliation: 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia.
authors.forename: Milana
authors.initials: M
authors.lastname: Panjkovic
authors.affiliation: 3. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kioumis
authors.affiliation: 2. Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Duisburg-Essen, 45239 Essen, Germany.
authors.forename: Kaid
authors.initials: K
authors.lastname: Darwiche
authors.affiliation: 3. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
authors.affiliation: 4. Department of Interventional Pneumology, "Sotiria" Hospital of Chest Diseases, Athens, Greece.
authors.forename: Grigoris
authors.initials: G
authors.lastname: Stratakos
authors.affiliation: 3. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Drosos
authors.initials: D
authors.lastname: Tsavlis
authors.affiliation: 5. Medical Clinic I, ''Fuerth'' Hospital, University of Erlangen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hohenforst-Schmidt
authors.affiliation: 3. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Pitsiou
authors.affiliation: 6. Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Zissimopoulos
authors.affiliation: 7. Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Sachpekidis
authors.affiliation: 8. Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
authors.forename: Ilias
authors.initials: I
authors.lastname: Karapantzos
authors.affiliation: 8. Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Karapantzou
authors.affiliation: 3. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: 1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia.
authors.forename: Branislav
authors.initials: B
authors.lastname: Perin
keywords: EBUS; bronchoscopy; endobronchial ultrasound; interventional pulmonology, lung cancer; peripheral pulmonary lesion