title: Safety and Efficacy of Radial EBUS for the Investigation of Peripheral Pulmonary Lesions in Patients With Advanced COPD.
abstract: BACKGROUND
  Peripheral pulmonary lesion (PPL) is a common scenario in patients with chronic obstructive pulmonary disease (COPD) and represents a high risk of malignancy. Severe COPD is associated with higher complication rates following percutaneous biopsy, and routine bronchoscopy. Safety and diagnostic performance of radial endobronchial ultrasound bronchoscopy (R-EBUS) in patients with advanced COPD has not been previously assessed.
  
  
  METHODS
  We examined a retrospective cohort of patients with advanced COPD undergoing R-EBUS for the evaluation of PPL.
  
  
  RESULTS
  During the study period, 92 patients underwent 94 R-EBUS procedures. In 50 cases, patients had severe obstructive deficit with mean forced expiratory volume in 1 second (FEV1) of 1.01±0.28 L, and FEV1% predicted 39.7±8.2. In 44 cases, patients had mild-moderate obstruction with severe diffusion impairment, with mean diffusion capacity for carbon monoxide% predicted of 41.2±7.9. Pneumothorax requiring intercostal catheter insertion occurred in 2 patients (2.1%). In 10 cases (10.6%; 95% confidence interval, 4.4%-16.8%) patients experienced acute respiratory failure. Diagnostic yield was 63% (59/94) and overall sensitivity for primary lung malignancy was 70% (53/76). Nine patients had a diagnosis on R-EBUS obviating lung resection.
  
  
  CONCLUSIONS
  R-EBUS is safe and accurate for the investigation of PPL in patients with advanced COPD.
authors.affiliation: Department of Respiratory Medicine, Royal Melbourne Hospital, Parkville, Melbourne, Vic., Australia.
authors.forename: Harry D
authors.initials: HD
authors.lastname: Georgiou
authors.forename: John
authors.initials: J
authors.lastname: Taverner
authors.forename: Louis B
authors.initials: LB
authors.lastname: Irving
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Steinfort
mesh_terms: D000368:Aged; D019160:Endosonography / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D012131:Respiratory Insufficiency / Q000453:epidemiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed