Factors affecting the diagnostic yield of transbronchial biopsy using endobronchial ultrasonography with a guide sheath in peripheral lung cancer

Shotaro Okachi, Naoyuki Imai, Kazuyoshi Imaizumi, Shingo Iwano, Masahiko Ando, Tetsunari Hase, Hiromichi Aso, Masahiro Morise, Keiko Wakahara, Satoru Ito, Naozumi Hashimoto, Mitsuo Sato, Masashi Kondo, Yoshinori Hasegawa

Research output: Contribution to journalArticle

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Abstract

Objective Endobronchial ultrasonography with a guide sheath (EBUS-GS) and virtual bronchoscopic navigation (VBN) improves the diagnostic yield in patients with peripheral pulmonary lesions (PPLs). Most previous reports on EBUS-GS-guided transbronchial biopsy (TBB) have included patients with benign and malignant diseases. We aimed to determine the factors that predicted a successful diagnosis by EBUS-GS-guided TBB diagnostic in patients with small peripheral lung cancer, with a focus on the high-resolution computed tomography (HRCT) findings before bronchoscopy. Methods We retrospectively reviewed the medical records of 173 consecutive patients with 175 small (≤30 mm) PPLs who were diagnosed with primary lung cancer between June 2010 and October 2013 at Nagoya University Hospital. All patients underwent EBUS-GS-guided TBB with VBN using a ZioStation computer workstation (Ziosoft, Osaka, Japan). We analyzed the patient characteristics, HRCT findings, diagnostic yield, and the diagnostic factors in small peripheral lung carcinoma. Results The EBUS probe position was within the PPL in 83 of the 175 lesions (47%) and 112 (64.0%) cases were successfully diagnosed by EBUS-GS-guided TBB. A univariate analysis revealed that the following factors were associated with a significantly higher diagnostic yield: CT bronchus sign positivity, a lesion of >20 mm in diameter, a solid nodule, and a probe position that was within the lesion. The following factors were not significant: the lesion location, the number of biopsies, and the lung cancer histology. A multivariate analysis revealed that the following factors significantly affected the diagnostic yield: CT bronchus sign positivity [odds ratio (OR) =2.479]; a probe position that was within the lesion (OR=2.542); and a solid nodule (OR=2.304). Conclusion The significant factors that were significantly associated with a successful diagnosis using EBUS-GS-guided TBB in small peripheral lung carcinoma were as follows: CT bronchus sign positivity, a solid nodule, and a probe position that was within the lesion.

Original languageEnglish
Pages (from-to)1705-1712
Number of pages8
JournalInternal Medicine
Volume55
Issue number13
DOIs
Publication statusPublished - 01-01-2016

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Ultrasonography
Lung Neoplasms
Biopsy
Bronchi
Lung
Odds Ratio
Tomography
Carcinoma
Bronchoscopy
Medical Records
Histology
Japan
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Okachi, Shotaro ; Imai, Naoyuki ; Imaizumi, Kazuyoshi ; Iwano, Shingo ; Ando, Masahiko ; Hase, Tetsunari ; Aso, Hiromichi ; Morise, Masahiro ; Wakahara, Keiko ; Ito, Satoru ; Hashimoto, Naozumi ; Sato, Mitsuo ; Kondo, Masashi ; Hasegawa, Yoshinori. / Factors affecting the diagnostic yield of transbronchial biopsy using endobronchial ultrasonography with a guide sheath in peripheral lung cancer. In: Internal Medicine. 2016 ; Vol. 55, No. 13. pp. 1705-1712.
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title = "Factors affecting the diagnostic yield of transbronchial biopsy using endobronchial ultrasonography with a guide sheath in peripheral lung cancer",
abstract = "Objective Endobronchial ultrasonography with a guide sheath (EBUS-GS) and virtual bronchoscopic navigation (VBN) improves the diagnostic yield in patients with peripheral pulmonary lesions (PPLs). Most previous reports on EBUS-GS-guided transbronchial biopsy (TBB) have included patients with benign and malignant diseases. We aimed to determine the factors that predicted a successful diagnosis by EBUS-GS-guided TBB diagnostic in patients with small peripheral lung cancer, with a focus on the high-resolution computed tomography (HRCT) findings before bronchoscopy. Methods We retrospectively reviewed the medical records of 173 consecutive patients with 175 small (≤30 mm) PPLs who were diagnosed with primary lung cancer between June 2010 and October 2013 at Nagoya University Hospital. All patients underwent EBUS-GS-guided TBB with VBN using a ZioStation computer workstation (Ziosoft, Osaka, Japan). We analyzed the patient characteristics, HRCT findings, diagnostic yield, and the diagnostic factors in small peripheral lung carcinoma. Results The EBUS probe position was within the PPL in 83 of the 175 lesions (47{\%}) and 112 (64.0{\%}) cases were successfully diagnosed by EBUS-GS-guided TBB. A univariate analysis revealed that the following factors were associated with a significantly higher diagnostic yield: CT bronchus sign positivity, a lesion of >20 mm in diameter, a solid nodule, and a probe position that was within the lesion. The following factors were not significant: the lesion location, the number of biopsies, and the lung cancer histology. A multivariate analysis revealed that the following factors significantly affected the diagnostic yield: CT bronchus sign positivity [odds ratio (OR) =2.479]; a probe position that was within the lesion (OR=2.542); and a solid nodule (OR=2.304). Conclusion The significant factors that were significantly associated with a successful diagnosis using EBUS-GS-guided TBB in small peripheral lung carcinoma were as follows: CT bronchus sign positivity, a solid nodule, and a probe position that was within the lesion.",
author = "Shotaro Okachi and Naoyuki Imai and Kazuyoshi Imaizumi and Shingo Iwano and Masahiko Ando and Tetsunari Hase and Hiromichi Aso and Masahiro Morise and Keiko Wakahara and Satoru Ito and Naozumi Hashimoto and Mitsuo Sato and Masashi Kondo and Yoshinori Hasegawa",
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Okachi, S, Imai, N, Imaizumi, K, Iwano, S, Ando, M, Hase, T, Aso, H, Morise, M, Wakahara, K, Ito, S, Hashimoto, N, Sato, M, Kondo, M & Hasegawa, Y 2016, 'Factors affecting the diagnostic yield of transbronchial biopsy using endobronchial ultrasonography with a guide sheath in peripheral lung cancer', Internal Medicine, vol. 55, no. 13, pp. 1705-1712. https://doi.org/10.2169/internalmedicine.55.6341

Factors affecting the diagnostic yield of transbronchial biopsy using endobronchial ultrasonography with a guide sheath in peripheral lung cancer. / Okachi, Shotaro; Imai, Naoyuki; Imaizumi, Kazuyoshi; Iwano, Shingo; Ando, Masahiko; Hase, Tetsunari; Aso, Hiromichi; Morise, Masahiro; Wakahara, Keiko; Ito, Satoru; Hashimoto, Naozumi; Sato, Mitsuo; Kondo, Masashi; Hasegawa, Yoshinori.

In: Internal Medicine, Vol. 55, No. 13, 01.01.2016, p. 1705-1712.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors affecting the diagnostic yield of transbronchial biopsy using endobronchial ultrasonography with a guide sheath in peripheral lung cancer

AU - Okachi, Shotaro

AU - Imai, Naoyuki

AU - Imaizumi, Kazuyoshi

AU - Iwano, Shingo

AU - Ando, Masahiko

AU - Hase, Tetsunari

AU - Aso, Hiromichi

AU - Morise, Masahiro

AU - Wakahara, Keiko

AU - Ito, Satoru

AU - Hashimoto, Naozumi

AU - Sato, Mitsuo

AU - Kondo, Masashi

AU - Hasegawa, Yoshinori

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objective Endobronchial ultrasonography with a guide sheath (EBUS-GS) and virtual bronchoscopic navigation (VBN) improves the diagnostic yield in patients with peripheral pulmonary lesions (PPLs). Most previous reports on EBUS-GS-guided transbronchial biopsy (TBB) have included patients with benign and malignant diseases. We aimed to determine the factors that predicted a successful diagnosis by EBUS-GS-guided TBB diagnostic in patients with small peripheral lung cancer, with a focus on the high-resolution computed tomography (HRCT) findings before bronchoscopy. Methods We retrospectively reviewed the medical records of 173 consecutive patients with 175 small (≤30 mm) PPLs who were diagnosed with primary lung cancer between June 2010 and October 2013 at Nagoya University Hospital. All patients underwent EBUS-GS-guided TBB with VBN using a ZioStation computer workstation (Ziosoft, Osaka, Japan). We analyzed the patient characteristics, HRCT findings, diagnostic yield, and the diagnostic factors in small peripheral lung carcinoma. Results The EBUS probe position was within the PPL in 83 of the 175 lesions (47%) and 112 (64.0%) cases were successfully diagnosed by EBUS-GS-guided TBB. A univariate analysis revealed that the following factors were associated with a significantly higher diagnostic yield: CT bronchus sign positivity, a lesion of >20 mm in diameter, a solid nodule, and a probe position that was within the lesion. The following factors were not significant: the lesion location, the number of biopsies, and the lung cancer histology. A multivariate analysis revealed that the following factors significantly affected the diagnostic yield: CT bronchus sign positivity [odds ratio (OR) =2.479]; a probe position that was within the lesion (OR=2.542); and a solid nodule (OR=2.304). Conclusion The significant factors that were significantly associated with a successful diagnosis using EBUS-GS-guided TBB in small peripheral lung carcinoma were as follows: CT bronchus sign positivity, a solid nodule, and a probe position that was within the lesion.

AB - Objective Endobronchial ultrasonography with a guide sheath (EBUS-GS) and virtual bronchoscopic navigation (VBN) improves the diagnostic yield in patients with peripheral pulmonary lesions (PPLs). Most previous reports on EBUS-GS-guided transbronchial biopsy (TBB) have included patients with benign and malignant diseases. We aimed to determine the factors that predicted a successful diagnosis by EBUS-GS-guided TBB diagnostic in patients with small peripheral lung cancer, with a focus on the high-resolution computed tomography (HRCT) findings before bronchoscopy. Methods We retrospectively reviewed the medical records of 173 consecutive patients with 175 small (≤30 mm) PPLs who were diagnosed with primary lung cancer between June 2010 and October 2013 at Nagoya University Hospital. All patients underwent EBUS-GS-guided TBB with VBN using a ZioStation computer workstation (Ziosoft, Osaka, Japan). We analyzed the patient characteristics, HRCT findings, diagnostic yield, and the diagnostic factors in small peripheral lung carcinoma. Results The EBUS probe position was within the PPL in 83 of the 175 lesions (47%) and 112 (64.0%) cases were successfully diagnosed by EBUS-GS-guided TBB. A univariate analysis revealed that the following factors were associated with a significantly higher diagnostic yield: CT bronchus sign positivity, a lesion of >20 mm in diameter, a solid nodule, and a probe position that was within the lesion. The following factors were not significant: the lesion location, the number of biopsies, and the lung cancer histology. A multivariate analysis revealed that the following factors significantly affected the diagnostic yield: CT bronchus sign positivity [odds ratio (OR) =2.479]; a probe position that was within the lesion (OR=2.542); and a solid nodule (OR=2.304). Conclusion The significant factors that were significantly associated with a successful diagnosis using EBUS-GS-guided TBB in small peripheral lung carcinoma were as follows: CT bronchus sign positivity, a solid nodule, and a probe position that was within the lesion.

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