Bronchus sign on thin-section computed tomography is a powerful predictive factor for successful transbronchial biopsy using endobronchial ultrasound with a guide sheath for small peripheral lung lesions: A retrospective observational study

Tomoyuki Minezawa, Takuya Okamura, Hiroshi Yatsuya, Naoki Yamamoto, Sayako Morikawa, Teppei Yamaguchi, Mariko Morishita, Yoshikazu Niwa, Tomoko Takeyama, Yuki Mieno, Tami Hoshino, Sakurako Uozu, Yasuhiro Goto, Masamichi Hayashi, Sumito Isogai, Masaki Matsuo, Toru Nakanishi, Naozumi Hashimoto, Mitsushi Okazawa, Kazuyoshi Imaizumi

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Recent advances in bronchoscopy, such as transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS), have improved the diagnostic yield of small-sized peripheral lung lesions. In some cases, however, it is difficult to obtain adequate biopsy samples for pathological diagnosis. Adequate prediction of the diagnostic accuracy of TBB with EBUS-GS is important before deciding whether bronchoscopy should be performed. Methods: We retrospectively reviewed 149 consecutive patients who underwent TBB with EBUS-GS for small-sized peripheral lung lesions (≤30 mm in diameter) from April 2012 to March 2013. We conducted an exploratory analysis to identify clinical factors that can predict an accurate diagnosis by TBB with EBUS-GS. All patients underwent thin-section chest computed tomography (CT) scans (0.5-mm slices), and the CT bronchus sign was evaluated before bronchoscopy in a group discussion. The final diagnoses were pathologically or clinically confirmed in all studied patients (malignant lesions, 110 patients; benign lesions, 39 patients). Results: The total diagnostic yield in this study was 72.5 % (95 % confidence interval: 64.8-79.0 %). Lesion size, lesion visibility on chest X-ray, and classification of the CT bronchus sign were factors significantly associated with the definitive biopsy result in the univariate analysis. In the multivariate analysis, only the CT bronchus sign remained as a significant predictive factor for successful bronchoscopic diagnosis. The CT bronchus sign was also significantly associated with the EBUS findings of the lesions. Conclusion: Our results suggest that the CT bronchus sign is a powerful predictive factor for successful TBB with EBUS-GS.

Original languageEnglish
Article number21
JournalBMC Medical Imaging
Volume15
Issue number1
DOIs
Publication statusPublished - 21-06-2015

Fingerprint

Bronchi
Observational Studies
Retrospective Studies
Tomography
Biopsy
Lung
Ultrasonography
Bronchoscopy
Thorax
X Ray Computed Tomography
Multivariate Analysis
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Minezawa, Tomoyuki ; Okamura, Takuya ; Yatsuya, Hiroshi ; Yamamoto, Naoki ; Morikawa, Sayako ; Yamaguchi, Teppei ; Morishita, Mariko ; Niwa, Yoshikazu ; Takeyama, Tomoko ; Mieno, Yuki ; Hoshino, Tami ; Uozu, Sakurako ; Goto, Yasuhiro ; Hayashi, Masamichi ; Isogai, Sumito ; Matsuo, Masaki ; Nakanishi, Toru ; Hashimoto, Naozumi ; Okazawa, Mitsushi ; Imaizumi, Kazuyoshi. / Bronchus sign on thin-section computed tomography is a powerful predictive factor for successful transbronchial biopsy using endobronchial ultrasound with a guide sheath for small peripheral lung lesions : A retrospective observational study. In: BMC Medical Imaging. 2015 ; Vol. 15, No. 1.
@article{27d837c4b89049ccab4b1ac3f176a389,
title = "Bronchus sign on thin-section computed tomography is a powerful predictive factor for successful transbronchial biopsy using endobronchial ultrasound with a guide sheath for small peripheral lung lesions: A retrospective observational study",
abstract = "Background: Recent advances in bronchoscopy, such as transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS), have improved the diagnostic yield of small-sized peripheral lung lesions. In some cases, however, it is difficult to obtain adequate biopsy samples for pathological diagnosis. Adequate prediction of the diagnostic accuracy of TBB with EBUS-GS is important before deciding whether bronchoscopy should be performed. Methods: We retrospectively reviewed 149 consecutive patients who underwent TBB with EBUS-GS for small-sized peripheral lung lesions (≤30 mm in diameter) from April 2012 to March 2013. We conducted an exploratory analysis to identify clinical factors that can predict an accurate diagnosis by TBB with EBUS-GS. All patients underwent thin-section chest computed tomography (CT) scans (0.5-mm slices), and the CT bronchus sign was evaluated before bronchoscopy in a group discussion. The final diagnoses were pathologically or clinically confirmed in all studied patients (malignant lesions, 110 patients; benign lesions, 39 patients). Results: The total diagnostic yield in this study was 72.5 {\%} (95 {\%} confidence interval: 64.8-79.0 {\%}). Lesion size, lesion visibility on chest X-ray, and classification of the CT bronchus sign were factors significantly associated with the definitive biopsy result in the univariate analysis. In the multivariate analysis, only the CT bronchus sign remained as a significant predictive factor for successful bronchoscopic diagnosis. The CT bronchus sign was also significantly associated with the EBUS findings of the lesions. Conclusion: Our results suggest that the CT bronchus sign is a powerful predictive factor for successful TBB with EBUS-GS.",
author = "Tomoyuki Minezawa and Takuya Okamura and Hiroshi Yatsuya and Naoki Yamamoto and Sayako Morikawa and Teppei Yamaguchi and Mariko Morishita and Yoshikazu Niwa and Tomoko Takeyama and Yuki Mieno and Tami Hoshino and Sakurako Uozu and Yasuhiro Goto and Masamichi Hayashi and Sumito Isogai and Masaki Matsuo and Toru Nakanishi and Naozumi Hashimoto and Mitsushi Okazawa and Kazuyoshi Imaizumi",
year = "2015",
month = "6",
day = "21",
doi = "10.1186/s12880-015-0060-5",
language = "English",
volume = "15",
journal = "BMC Medical Imaging",
issn = "1471-2342",
publisher = "BioMed Central",
number = "1",

}

Minezawa, T, Okamura, T, Yatsuya, H, Yamamoto, N, Morikawa, S, Yamaguchi, T, Morishita, M, Niwa, Y, Takeyama, T, Mieno, Y, Hoshino, T, Uozu, S, Goto, Y, Hayashi, M, Isogai, S, Matsuo, M, Nakanishi, T, Hashimoto, N, Okazawa, M & Imaizumi, K 2015, 'Bronchus sign on thin-section computed tomography is a powerful predictive factor for successful transbronchial biopsy using endobronchial ultrasound with a guide sheath for small peripheral lung lesions: A retrospective observational study', BMC Medical Imaging, vol. 15, no. 1, 21. https://doi.org/10.1186/s12880-015-0060-5

Bronchus sign on thin-section computed tomography is a powerful predictive factor for successful transbronchial biopsy using endobronchial ultrasound with a guide sheath for small peripheral lung lesions : A retrospective observational study. / Minezawa, Tomoyuki; Okamura, Takuya; Yatsuya, Hiroshi; Yamamoto, Naoki; Morikawa, Sayako; Yamaguchi, Teppei; Morishita, Mariko; Niwa, Yoshikazu; Takeyama, Tomoko; Mieno, Yuki; Hoshino, Tami; Uozu, Sakurako; Goto, Yasuhiro; Hayashi, Masamichi; Isogai, Sumito; Matsuo, Masaki; Nakanishi, Toru; Hashimoto, Naozumi; Okazawa, Mitsushi; Imaizumi, Kazuyoshi.

In: BMC Medical Imaging, Vol. 15, No. 1, 21, 21.06.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Bronchus sign on thin-section computed tomography is a powerful predictive factor for successful transbronchial biopsy using endobronchial ultrasound with a guide sheath for small peripheral lung lesions

T2 - A retrospective observational study

AU - Minezawa, Tomoyuki

AU - Okamura, Takuya

AU - Yatsuya, Hiroshi

AU - Yamamoto, Naoki

AU - Morikawa, Sayako

AU - Yamaguchi, Teppei

AU - Morishita, Mariko

AU - Niwa, Yoshikazu

AU - Takeyama, Tomoko

AU - Mieno, Yuki

AU - Hoshino, Tami

AU - Uozu, Sakurako

AU - Goto, Yasuhiro

AU - Hayashi, Masamichi

AU - Isogai, Sumito

AU - Matsuo, Masaki

AU - Nakanishi, Toru

AU - Hashimoto, Naozumi

AU - Okazawa, Mitsushi

AU - Imaizumi, Kazuyoshi

PY - 2015/6/21

Y1 - 2015/6/21

N2 - Background: Recent advances in bronchoscopy, such as transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS), have improved the diagnostic yield of small-sized peripheral lung lesions. In some cases, however, it is difficult to obtain adequate biopsy samples for pathological diagnosis. Adequate prediction of the diagnostic accuracy of TBB with EBUS-GS is important before deciding whether bronchoscopy should be performed. Methods: We retrospectively reviewed 149 consecutive patients who underwent TBB with EBUS-GS for small-sized peripheral lung lesions (≤30 mm in diameter) from April 2012 to March 2013. We conducted an exploratory analysis to identify clinical factors that can predict an accurate diagnosis by TBB with EBUS-GS. All patients underwent thin-section chest computed tomography (CT) scans (0.5-mm slices), and the CT bronchus sign was evaluated before bronchoscopy in a group discussion. The final diagnoses were pathologically or clinically confirmed in all studied patients (malignant lesions, 110 patients; benign lesions, 39 patients). Results: The total diagnostic yield in this study was 72.5 % (95 % confidence interval: 64.8-79.0 %). Lesion size, lesion visibility on chest X-ray, and classification of the CT bronchus sign were factors significantly associated with the definitive biopsy result in the univariate analysis. In the multivariate analysis, only the CT bronchus sign remained as a significant predictive factor for successful bronchoscopic diagnosis. The CT bronchus sign was also significantly associated with the EBUS findings of the lesions. Conclusion: Our results suggest that the CT bronchus sign is a powerful predictive factor for successful TBB with EBUS-GS.

AB - Background: Recent advances in bronchoscopy, such as transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS), have improved the diagnostic yield of small-sized peripheral lung lesions. In some cases, however, it is difficult to obtain adequate biopsy samples for pathological diagnosis. Adequate prediction of the diagnostic accuracy of TBB with EBUS-GS is important before deciding whether bronchoscopy should be performed. Methods: We retrospectively reviewed 149 consecutive patients who underwent TBB with EBUS-GS for small-sized peripheral lung lesions (≤30 mm in diameter) from April 2012 to March 2013. We conducted an exploratory analysis to identify clinical factors that can predict an accurate diagnosis by TBB with EBUS-GS. All patients underwent thin-section chest computed tomography (CT) scans (0.5-mm slices), and the CT bronchus sign was evaluated before bronchoscopy in a group discussion. The final diagnoses were pathologically or clinically confirmed in all studied patients (malignant lesions, 110 patients; benign lesions, 39 patients). Results: The total diagnostic yield in this study was 72.5 % (95 % confidence interval: 64.8-79.0 %). Lesion size, lesion visibility on chest X-ray, and classification of the CT bronchus sign were factors significantly associated with the definitive biopsy result in the univariate analysis. In the multivariate analysis, only the CT bronchus sign remained as a significant predictive factor for successful bronchoscopic diagnosis. The CT bronchus sign was also significantly associated with the EBUS findings of the lesions. Conclusion: Our results suggest that the CT bronchus sign is a powerful predictive factor for successful TBB with EBUS-GS.

UR - http://www.scopus.com/inward/record.url?scp=84931058602&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84931058602&partnerID=8YFLogxK

U2 - 10.1186/s12880-015-0060-5

DO - 10.1186/s12880-015-0060-5

M3 - Article

C2 - 26092497

AN - SCOPUS:84931058602

VL - 15

JO - BMC Medical Imaging

JF - BMC Medical Imaging

SN - 1471-2342

IS - 1

M1 - 21

ER -