Abstract
The aim was to evaluate the diagnostic value of fluoroscopy-guided fibrobronchoscopy biopsy techniques (FBBT) and image guided transthoracic needle biopsy (TTNB) for diagnosing peripheral pulmonary lesions (PPL).
Materials and methods: In a prospective study we observed 960 patients with PLL above 10 mm in diameter (d) (͞x = 48 mm +/- SD 22mm). In 172 patients we carried out FBBT: conventional (CBT: forceps, brush and washing) and transbronchial aspiration biopsy (TBAB). In 720 patients with PPL suitable for US visualization we performed US guided transthoracic true cut needle biopsy (US-TCNB). In 80 of them it was preceded by aspiration needle biopsy (US-TTAB). In 68 patients with PPL unsuitable for US visualization we performed CT guided TTAB (d<30 mm) and TCNB (d >30 mm). The biopsy specimens were examined with light microscopy and immunohistological analysis.
Results: The Se of US-TCNB significantly exceeded Se of FBBT CBT+TBAB (p<0.001), Se of US-TTAB (p<0.001), Se of CT-TTNB (p<0.025).
The diagnostic yield of FBBT was significantly lower for smaller PPL. We observed few complications of US-TCNB (<1%), comparing to the complication rate of CT-TTNB (19%) and FGFB (5%).
Conclusion: US–TCNB was the most effective and a safe diagnostic method in the patients with PPL accessible to US visualization. The application of FGFB techniques ensured combination of high diagnostic value, low complication rate and important information for staging.
- © 2014 ERS