title: Transbronchial Lung Cryobiopsy in Diffuse Parenchymal Lung Disease: Comparison between Biopsy from 1 Segment and Biopsy from 2 Segments - Diagnostic Yield and Complications.
abstract: BACKGROUND
  Transbronchial lung cryobiopsy is an innovative method of obtaining samples from the parenchyma of patients with diffuse parenchymal lung diseases. However, the technique is not yet standardized, and uncertainty exists about the optimal protocol, including the number of samples, the biopsy size, and the choice of the biopsy site.
  
  
  OBJECTIVE
  To compare the diagnostic yield and complications of cryobiopsy with different strategies adopted to sample lung tissue (number of samples, biopsy site, and sample size).
  
  
  METHODS
  We prospectively enrolled 46 patients with suspected diffuse parenchymal lung diseases for the diagnosis of which a biopsy was deemed useful. All patients underwent transbronchial lung cryobiopsy, and they were randomly assigned to group A (4 samples obtained from the same segment) or group B (2 samples obtained from one segment and 2 samples obtained from a different segment of the same lobe). Analysis of the samples was performed sequentially (from the first to the last sample), and pathologists reformulated their histopathologic diagnosis with the addition of each sample.
  
  
  RESULTS
  The mean diagnostic yield of the procedure combining the 2 groups and performing only the first sampling was 69%. When a second biopsy was performed as well, the mean diagnostic yield improved, but this increase was significant only when the 2 samples were obtained from 2 different segments (96%, group B).
  
  
  CONCLUSIONS
  This study suggests that the strategy of performing 2 biopsies with a cryoprobe may be associated with an increased diagnostic yield in diffuse parenchymal lung diseases if these samples are obtained from 2 different segments within the same lobe.
authors.affiliation: Department of Diseases of the Thorax, G.B. Morgagni - L. Pierantoni Hospital, Forlì, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Ravaglia
authors.forename: Athol U
authors.initials: AU
authors.lastname: Wells
authors.forename: Sara
authors.initials: S
authors.lastname: Tomassetti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Dubini
authors.forename: Alberto
authors.initials: A
authors.lastname: Cavazza
authors.forename: Sara
authors.initials: S
authors.lastname: Piciucchi
authors.forename: Nicola
authors.initials: N
authors.lastname: Sverzellati
authors.forename: Carlo
authors.initials: C
authors.lastname: Gurioli
authors.forename: Christian
authors.initials: C
authors.lastname: Gurioli
authors.forename: Ulrich
authors.initials: U
authors.lastname: Costabel
authors.forename: Paola
authors.initials: P
authors.lastname: Tantalocco
authors.forename: Jay H
authors.initials: JH
authors.lastname: Ryu
authors.forename: Marco
authors.initials: M
authors.lastname: Chilosi
authors.forename: Venerino
authors.initials: V
authors.lastname: Poletti
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000009:adverse effects / Q000379:methods*; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods; D003452:Cryosurgery; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies