Transbronchial Cryobiopsy for the Diagnosis of Peripheral Pulmonary Lesions: A Prospective Randomized Controlled Study.
Ying Liang, Hong Zhou, Jie Wu et al.
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In 30 seconds
This prospective, single-center randomized controlled study compared radial endobronchial ultrasound with guide-sheath-assisted transbronchial cryobiopsy (TBCB) using a 1.1-mm ultrathin probe with conventional forceps biopsy in patients with peripheral pulmonary lesions. After successful lesion localization, 50 patients were randomized, 25 per group. Pathological diagnostic yield was 84.0% with TBCB and 64.0% with forceps biopsy, a difference that was not statistically significant (p = 0.107). TBCB produced larger histologic specimens and less severe crush artifact; bleeding and pneumothorax were also reported.
Key findings
- Pathological diagnostic yield was 84.0% with TBCB versus 64.0% with forceps biopsy (p = 0.107).
- Maximum total histologic tissue area was 14.6 ± 4.2 mm² with TBCB versus 3.1 ± 0.9 mm² with forceps biopsy (p < 0.001).
- Severe crush artifact occurred in 8.0% with TBCB versus 52.0% with forceps biopsy (p < 0.001).
- Grade 2 bleeding occurred in 32.0% versus 24.0%; no Grade 3 bleeding occurred, and one TBCB patient developed pneumothorax.
Why it matters
Peripheral lesions can be difficult to diagnose bronchoscopically, and specimen quality affects pathological assessment. In this randomized comparison, ultrathin cryobiopsy provided larger, better-preserved tissue, but the study did not demonstrate a statistically significant improvement in diagnostic yield. These results help distinguish improved specimen characteristics from proven gains in diagnostic performance.
What to keep in mind
The study was single-center and included only 50 patients; the diagnostic-yield difference was not statistically significant.