Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study

Background Radial endobronchial ultrasonography (R-EBUS) has been used in conjunction with transbronchial lung cryobiopsy (TBLC) to diagnose diffuse parenchymal lung disease (DPLD) and to decrease the risk of bleeding complications. The diagnostic utility of different R-EBUS signs, however, remains...

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Autores principales:	Kohei Takada, Minoru Inomata, Naoyuki Kuse, Nobuyasu Awano, Mari Tone, Hanako Yoshimura, Tatsunori Jo, Jonsu Minami, Yutaka Muto, Kazushi Fujimoto, Akinori Harada, Yuan Bae, Toshio Kumasaka, Hideaki Yamakawa, Shintaro Sato, Kazunori Tobino, Hidekazu Matsushima, Tamiko Takemura, Takehiro Izumo
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2021
Materias:	Medicine R Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/aea7bc2825e54e9d9d1703fcc5a51f03
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spelling	oai:doaj.org-article:aea7bc2825e54e9d9d1703fcc5a51f032021-11-17T06:00:05ZUtility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study10.1136/bmjresp-2020-0008262052-4439https://doaj.org/article/aea7bc2825e54e9d9d1703fcc5a51f032021-11-01T00:00:00Zhttps://bmjopenrespres.bmj.com/content/8/1/e000826.fullhttps://doaj.org/toc/2052-4439Background Radial endobronchial ultrasonography (R-EBUS) has been used in conjunction with transbronchial lung cryobiopsy (TBLC) to diagnose diffuse parenchymal lung disease (DPLD) and to decrease the risk of bleeding complications. The diagnostic utility of different R-EBUS signs, however, remains unknown.Objectives This study aimed to determine whether different R-EBUS signs could be used to more accurately diagnose DPLD and whether bronchial bleeding could be prevented with use of R-EBUS during TBLC.Method Eighty-seven patients with DPLD were included in this multicentre prospective study, with 49 patients undergoing R-EBUS. R-EBUS signals were characterised as displaying either dense or blizzard signs. Pathological confidence of specimens obtained from TBLC was compared between patients with dense versus blizzard signs, and severity of bronchial bleeding was determined based on whether R-EBUS was performed or not.Results All patients with dense signs on R-EBUS showed consolidation on high-resolution CT (HRCT) imaging. Pathological confidence of lung specimens was significantly higher in patients with dense signs versus those with blizzard signs (p<0.01) and versus those who did not undergo R-EBUS (p<0.05). Patients who underwent TBLC with R-EBUS were more likely to experience no or mild bronchial bleeding than patients who did not undergo R-EBUS (p<0.01), with shorter procedure times (p<0.01).Conclusions The dense R-EBUS sign corresponded with consolidation on HRCT. High-quality lung specimens may be obtainable when the dense sign is observed on R-EBUS, and R-EBUS combined with TBLC may reduce risk of bronchial bleeding and shorten procedure times.Kohei TakadaMinoru InomataNaoyuki KuseNobuyasu AwanoMari ToneHanako YoshimuraTatsunori JoJonsu MinamiYutaka MutoKazushi FujimotoAkinori HaradaYuan BaeToshio KumasakaHideaki YamakawaShintaro SatoKazunori TobinoHidekazu MatsushimaTamiko TakemuraTakehiro IzumoBMJ Publishing GrouparticleMedicineRDiseases of the respiratory systemRC705-779ENBMJ Open Respiratory Research, Vol 8, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Diseases of the respiratory system RC705-779
spellingShingle	Medicine R Diseases of the respiratory system RC705-779 Kohei Takada Minoru Inomata Naoyuki Kuse Nobuyasu Awano Mari Tone Hanako Yoshimura Tatsunori Jo Jonsu Minami Yutaka Muto Kazushi Fujimoto Akinori Harada Yuan Bae Toshio Kumasaka Hideaki Yamakawa Shintaro Sato Kazunori Tobino Hidekazu Matsushima Tamiko Takemura Takehiro Izumo Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study
description	Background Radial endobronchial ultrasonography (R-EBUS) has been used in conjunction with transbronchial lung cryobiopsy (TBLC) to diagnose diffuse parenchymal lung disease (DPLD) and to decrease the risk of bleeding complications. The diagnostic utility of different R-EBUS signs, however, remains unknown.Objectives This study aimed to determine whether different R-EBUS signs could be used to more accurately diagnose DPLD and whether bronchial bleeding could be prevented with use of R-EBUS during TBLC.Method Eighty-seven patients with DPLD were included in this multicentre prospective study, with 49 patients undergoing R-EBUS. R-EBUS signals were characterised as displaying either dense or blizzard signs. Pathological confidence of specimens obtained from TBLC was compared between patients with dense versus blizzard signs, and severity of bronchial bleeding was determined based on whether R-EBUS was performed or not.Results All patients with dense signs on R-EBUS showed consolidation on high-resolution CT (HRCT) imaging. Pathological confidence of lung specimens was significantly higher in patients with dense signs versus those with blizzard signs (p<0.01) and versus those who did not undergo R-EBUS (p<0.05). Patients who underwent TBLC with R-EBUS were more likely to experience no or mild bronchial bleeding than patients who did not undergo R-EBUS (p<0.01), with shorter procedure times (p<0.01).Conclusions The dense R-EBUS sign corresponded with consolidation on HRCT. High-quality lung specimens may be obtainable when the dense sign is observed on R-EBUS, and R-EBUS combined with TBLC may reduce risk of bronchial bleeding and shorten procedure times.
format	article
author	Kohei Takada Minoru Inomata Naoyuki Kuse Nobuyasu Awano Mari Tone Hanako Yoshimura Tatsunori Jo Jonsu Minami Yutaka Muto Kazushi Fujimoto Akinori Harada Yuan Bae Toshio Kumasaka Hideaki Yamakawa Shintaro Sato Kazunori Tobino Hidekazu Matsushima Tamiko Takemura Takehiro Izumo
author_facet	Kohei Takada Minoru Inomata Naoyuki Kuse Nobuyasu Awano Mari Tone Hanako Yoshimura Tatsunori Jo Jonsu Minami Yutaka Muto Kazushi Fujimoto Akinori Harada Yuan Bae Toshio Kumasaka Hideaki Yamakawa Shintaro Sato Kazunori Tobino Hidekazu Matsushima Tamiko Takemura Takehiro Izumo
author_sort	Kohei Takada
title	Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study
title_short	Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study
title_full	Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study
title_fullStr	Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study
title_full_unstemmed	Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study
title_sort	utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study
publisher	BMJ Publishing Group
publishDate	2021
url	https://doaj.org/article/aea7bc2825e54e9d9d1703fcc5a51f03
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Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study

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