title: Radial endobronchial ultrasound with a guide sheath for diagnosis of peripheral cavitary lung lesions: a retrospective study.
abstract: BACKGROUND
  Radial endobronchial ultrasound with a guide sheath (EBUS-GS) has improved the diagnostic outcomes of peripheral lung lesions. However, to our knowledge, reports on the use of EBUS-GS for diagnosis of cavitary lesions are unavailable. Therefore, this study aimed to assess the effectiveness and safety of EBUS-GS for diagnosis of peripheral cavitary lung lesions (PCLLs).
  
  
  METHODS
  This study was a single-institution retrospective review of PCLLs examined by using EBUS-GS between July 2013 and October 2015. The diagnostic results of different EBUS-GS samples, including cytologic, histopathologic, and microbiologic samples, were analysed separately.
  
  
  RESULTS
  Of 696 radial EBUS procedures performed during the study period, 50 were performed for examination of PCLLs. The overall diagnostic yield for EBUS-GS was 80 % (40/50). Regarding 27 malignant lesions, the diagnostic yields for cytologic and histopathologic samples were 63.0 % (17/27) and 74.1 % (20/27), respectively. Regarding 23 benign lesions, the diagnostic yields for histopathologic and microbiologic samples were 69.6 % (16/23) and 47.8 % (11/23), respectively. Uni- and multivariate analyses indicated that the EBUS probe being within the lesion was the only factor significantly associated with increased diagnostic yield (odds ratio, 7.04; P = 0.03). Although pulmonary infection occurred after the procedure in 1 patient (2.0 %), no other complications, including pneumothorax or significant haemorrhage, were reported.
  
  
  CONCLUSIONS
  EBUS-GS was found to be an effective and safe procedure for diagnosis of PCLLs.
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan. manabuhayama@gmail.com.
authors.forename: Manabu
authors.initials: M
authors.lastname: Hayama
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Okamoto
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Tamiya
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shiroyama
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Nishida
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishihara
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Uehara
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Morishita
authors.affiliation: Department of Pathology, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Osaka, Japan.
authors.forename: Kunimitsu
authors.initials: K
authors.lastname: Kawahara
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino City, Osaka, 583-8588, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Hirashima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D016208:Databases, Factual; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D007564:Japan; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography
keywords: Bronchoscopy; Cavity; Endobronchial ultrasound with a guide sheath; Lung cancer; Radial endobronchial ultrasound; Transbronchial biopsy; peripheral lung lesion