Usefulness of Endobronchial Ultrasonography With a Guide Sheath and Virtual Bronchoscopic Navigation for Ground-Glass Opacity Lesions.
BACKGROUND
Endobronchial ultrasonography with guide sheath (EBUS-GS) could be useful for diagnosing ground-glass opacity (GGO) predominant-type lesions in the peripheral lung. Furthermore, several studies have reported that transbronchial biopsy using EBUS-GS and virtual bronchoscopic navigation (VBN) was safe and effective for diagnosing small peripheral lung lesions. Our objectives were to diagnose solitary peripheral GGO predominant-type lesions by transbronchial biopsy using EBUS-GS and VBN under radiographic fluoroscopic guidance, and to evaluate the clinical factors associated with diagnostic yield.


METHODS
The medical records of 169 patients with GGO predominant-type lesions who underwent transbronchial biopsy using EBUS-GS and VBN under radiographic fluoroscopic guidance were retrospectively reviewed.


RESULTS
Endobronchial ultrasonography images could be obtained for 156 (92%) of 169 GGO predominant-type lesions, and 116 (69%) were successfully diagnosed by this method (20 of 31 pure GGO lesions [65%]; 96 of 138 mixed GGO predominant-type lesions [70%]). The mean size of diagnosed lesions was significantly larger than that of nondiagnosed lesions (22 mm versus 18 mm, p < 0.01). Regarding diagnostic yield based on computed tomography sign, cases with presence of a bronchus leading directly to a lesion had significantly higher diagnostic yield than the other lesions (p < 0.01).


CONCLUSIONS
The addition of VBN to EBUS-GS could be useful in clinical practice for diagnosing GGO predominant-type lesions in the peripheral lung.
First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Yasuyuki
Y
Ikezawa
First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan. Electronic address: naofu@med.hokudai.ac.jp.
Naofumi
N
Shinagawa
Respiratory Department, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
Noriaki
N
Sukoh
First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Megumi
M
Morimoto
First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Hajime
H
Kikuchi
Respiratory Department, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
Masahiro
M
Watanabe
Respiratory Department, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
Kosuke
K
Nakano
First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Satoshi
S
Oizumi
First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Masaharu
M
Nishimura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001999:Bronchoscopy / Q000379:methods; D015331:Cohort Studies; D019160:Endosonography / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006785:Hospitals, University; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D007564:Japan; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods*