Standard Bronchoscopy With Fluoroscopy vs Thin Bronchoscopy and Radial Endobronchial Ultrasound for Biopsy of Pulmonary Lesions: A Multicenter, Prospective, Randomized Trial

Chest
Nichole T TannerGerard A Silvestri

Abstract

New technology has resulted in bronchoscopy being increasingly used for diagnosing pulmonary lesions. Reported yield from these procedures varies widely with few randomized clinical trials. This study compares the diagnostic yield of a thin bronchoscope and radial endobronchial ultrasound (R-EBUS) with standard bronchoscopy and fluoroscopy (SB-F) in lung lesions. Patients presenting for diagnostic bronchoscopic evaluation at five centers were randomized to undergo SB-F or R-EBUS with a thin bronchoscope (TB-EBUS). If SB-F was nondiagnostic, crossover to the TB-EBUS arm was allowed. Data on patient demographics, radiographic features, and final pathologic or radiographic follow-up were collected. Statistical comparisons were made by Fisher exact test, χ2 test, and Student t test. Bivariate and multivariate analyses were performed to determine predictors of diagnostic yield. One hundred and ninety-seven patients were included in the final analyses. There was no difference in demographics, lesion size, or location between study arms. The average lesion size was 31.2 mm (SD, 10.8 mm). Bronchoscopy was diagnostic in 87 patients (44%). Although the diagnostic yield was higher in the TB-EBUS arm compared with the SB-F arm (49% vs 37%)...Continue Reading

References

Oct 8, 2011·Chest·Jessica S Wang MemoliGerard A Silvestri
Jul 17, 2013·Annals of Internal Medicine·Peter B BachGerard A Silvestri
Mar 19, 2014·Annals of the American Thoracic Society·Alexander ChenDavid Misselhorn
May 20, 2015·The New England Journal of Medicine·Gerard A SilvestriUNKNOWN AEGIS Study Team
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Sep 15, 2015·American Journal of Respiratory and Critical Care Medicine·David E OstUNKNOWN AQuIRE Bronchoscopy Registry

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Citations

Jul 20, 2019·Expert Review of Respiratory Medicine·Tsukasa IshiwataKazuhiro Yasufuku
Jul 3, 2019·Respirology : Official Journal of the Asian Pacific Society of Respirology·Matt AboudaraFabien Maldonado
Feb 28, 2020·Respirology : Official Journal of the Asian Pacific Society of Respirology·David Fielding, Masahide Oki
May 31, 2019·Annals of the American Thoracic Society·Majid ShafiqDavid Feller-Kopman
Sep 4, 2020·European Respiratory Review : an Official Journal of the European Respiratory Society·Sharad Chandrika, Lonny Yarmus
Mar 27, 2019·Respirology : Official Journal of the Asian Pacific Society of Respirology·Tsukasa IshiwataKoichiro Tatsumi
Feb 6, 2020·American Journal of Respiratory and Critical Care Medicine·Gerard J CrinerFelix J Herth
Aug 29, 2020·BMC Pulmonary Medicine·Boxue HeXiang Wang
Nov 18, 2020·Respirology : Official Journal of the Asian Pacific Society of Respirology·Matthew AboudaraFabien Maldonado
Nov 18, 2020·Respirology : Official Journal of the Asian Pacific Society of Respirology·Taichiro Goto
Feb 6, 2020·Clinics in Chest Medicine·A Cole Burks, Jason Akulian
Apr 27, 2021·Expert Review of Respiratory Medicine·Satish KalanjeriJeremy C Johnson
Mar 19, 2021·Journal of Bronchology & Interventional Pulmonology·James KatsisFabien Maldonado
Dec 6, 2019·Respiration; International Review of Thoracic Diseases·Alexander C ChenGerard A Silvestri
Nov 11, 2019·Respiration; International Review of Thoracic Diseases·Lonny B YarmusUNKNOWN Interventional Pulmonary Outcomes Group (IPOG)
Nov 10, 2021·Current Opinion in Pulmonary Medicine·Stefano GaspariniLina Zuccatosta

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