Improved diagnostic yield of bronchoscopy in peripheral pulmonary lesions: combination of radial probe endobronchial ultrasound and rapid on-site evaluation

Chia-Hung Chen; Wen-Chien Cheng; Biing-Ru Wu; Chih-Yu Chen; Wei-Chun Chen; Te-Chun Hsia; Wei-Chih Liao; Chih-Yen Tu; Chuen-Ming Shih; Wu-Huei Hsu; Ko-Pen Wang

doi:10.3978/j.issn.2072-1439.2015.12.13

Improved diagnostic yield of bronchoscopy in peripheral pulmonary lesions: combination of radial probe endobronchial ultrasound and rapid on-site evaluation

J Thorac Dis. 2015 Dec;7(Suppl 4):S418-25. doi: 10.3978/j.issn.2072-1439.2015.12.13.

Authors

Affiliation

¹ 1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan ; 2 Department of Respiratory Therapy, 3 Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan ; 4 School of Medicine, China Medical University, Taichung, Taiwan ; 5 Department of Internal Medicine, Hyperbaric oxygen therapy center, China Medical University, Taichung, Taiwan ; 6 Department of Life Science, National Chung Hsing University, Taichung, Taiwan ; 7 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, School of Medicine Baltimore, Maryland, USA.

PMID: 26807290
PMCID: PMC4700367
DOI: 10.3978/j.issn.2072-1439.2015.12.13

Abstract

Background: Rapid on-site evaluation (ROSE) of cytologic specimens is a useful ancillary technique in needle aspiration procedures of pulmonary/mediastinal lesions, but few reports had been carried out to confirm the utility in the diagnosis of peripheral pulmonary lesions (PPLs) by radial probe endobronchial ultrasound (R-EBUS).

Methods: To evaluate the impact of ROSE on the diagnostic yield of R-EBUS for PPLs, we retrospectively analyzed the diagnostic yields of transbronchial biopsy (TBB) or brushing using R-EBUS for patients with PPLs in a tertiary university hospital from December 2012 to December 2014.

Results: A total of 815 patients with PPLs were included. A definite diagnosis was made by R-EBUS-guided TBB or brushing for 627 patients (76.9%). A total of 279 patients (34.2%) were examined by a ROSE technique. The combination of R-EBUS guided TBB or brushing with ROSE raised the diagnostic yield in the diagnosis of PPLs, especially difficult cases: right apical and left apical-posterior segment locations, small PPLs <3 cm without bronchus signs on computed tomography (CT) scan, PPLs with pleural effusions, and the position of probe is not within.

Conclusions: ROSE can improve the PPLs diagnostic yield when using R-EBUS guided TBB or brushing.

Keywords: Endobronchial ultrasound (EBUS); peripheral pulmonary lesion (PPL); rapid on-site evaluation (ROSE).