Home
|
Inbox
|
Search
|
View Abstract
Characteristics of Computed Tomography-Guided Bronchoscopy in Diagnosis of Small Peripheral Pulmonary Lesions
Description
.abstract img { width:300px !important; height:auto; display:block; text-align:center; margin-top:10px } .abstract { overflow-x:scroll } .abstract table { width:100%; display:block; border:hidden; border-collapse: collapse; margin-top:10px } .abstract td, th { border-top: 1px solid #ddd; padding: 4px 8px; } .abstract tbody tr:nth-child(even) td { background-color: #efefef; } .abstract a { overflow-wrap: break-word; word-wrap: break-word; }
A7300 - Characteristics of Computed Tomography-Guided Bronchoscopy in Diagnosis of Small Peripheral Pulmonary Lesions
Author Block: M. Yamanaka, M. Yasuo, Y. Kitaguchi, N. Kobayashi, K. Tateishi, K. Urushihata, A. Ushiki, H. Yamamoto, M. Hanaoka; The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Background
Both endobronchial ultrasonography with a guide sheath (EBUS-GS) and computed tomography (CT)-guided bronchoscopy have been developed to diagnose peripheral pulmonary lesions (PPLs). Previously, we reported that the diagnostic yield of PPLs by the CT-guided bronchoscopy with virtual bronchoscopic navigation (VBN) was 84.0%. The aim of the present study was to examine the factors those might affect the diagnostic yield of PPLs in the CT-guided bronchoscopy.
Methods
A total of 115 patients with PPLs in size of 20mm or smaller were performed CT-guided bronchoscopy with VBN in our respiratory center from December 2011 to April 2017. The information was retrospectively collected with respect of the PPLs in terms of the shadow patterns on CT, X-ray visibility, lesion size, lesion location, CT bronchus sign (CT-BS, the positional relationship of the PPLs with the nearby bronchus on CT), and number of tissue samplings. The data about patients with PPLs in negative CT-BS and those without recording examination time of the bronchoscopy were not included. The associations of the diagnostic yield of PPLs with those factors were analyzed.
Results
The average diagnostic yields of the PPLs by the CT-guided bronchoscopy were from 80% to 85% according to the concerned factors in terms of the shadow patterns of CT (ground glass opacity (GGO) pure, mixed or solid), X-ray visibility (invisible, difficult to detect or visible), lesion size (≦10mm, 10-15mm or 15-20mm), lesion location (peripheral or middle to proximal). The yields did not show significant difference between the CT-BS 1 and CT-BS 2 of PPLs. In addition, the number of tissue samplings did not affect the diagnostic yield. No serious adverse effects occurred during and after the CT-guided bronchoscopy.
Discussion
The CT-guided bronchoscopy provided a considerably high diagnostic yield of PPLs despite the variation of lesion characteristics. Recently, it has been reported that the diagnostic yield of PPLs by EBUS-GS was 70.6%. However, the diagnostic yield was relatively low for PPLs less than 20mm in size, X-ray invisible lesion, and EBUS located adjacent to the lesion. Interestingly, the advantage of CT-guided bronchoscopy for the diagnosis of the PPLs overcomes the limitations of the EBUS-GS. The present results suggest that the CT-guided bronchoscopy showed superior diagnostic potential than EBUS-GS especially if the PPLs were small less than 20mm and X-ray invisible.
Conclusions
The diagnostic ability of CT-guided bronchoscopy is satisfied with the diagnostic yield of PPLs regardless of the variations of lesion characteristics.
Author Block: M. Yamanaka, M. Yasuo, Y. Kitaguchi, N. Kobayashi, K. Tateishi, K. Urushihata, A. Ushiki, H. Yamamoto, M. Hanaoka; The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Background
Both endobronchial ultrasonography with a guide sheath (EBUS-GS) and computed tomography (CT)-guided bronchoscopy have been developed to diagnose peripheral pulmonary lesions (PPLs). Previously, we reported that the diagnostic yield of PPLs by the CT-guided bronchoscopy with virtual bronchoscopic navigation (VBN) was 84.0%. The aim of the present study was to examine the factors those might affect the diagnostic yield of PPLs in the CT-guided bronchoscopy.
Methods
A total of 115 patients with PPLs in size of 20mm or smaller were performed CT-guided bronchoscopy with VBN in our respiratory center from December 2011 to April 2017. The information was retrospectively collected with respect of the PPLs in terms of the shadow patterns on CT, X-ray visibility, lesion size, lesion location, CT bronchus sign (CT-BS, the positional relationship of the PPLs with the nearby bronchus on CT), and number of tissue samplings. The data about patients with PPLs in negative CT-BS and those without recording examination time of the bronchoscopy were not included. The associations of the diagnostic yield of PPLs with those factors were analyzed.
Results
The average diagnostic yields of the PPLs by the CT-guided bronchoscopy were from 80% to 85% according to the concerned factors in terms of the shadow patterns of CT (ground glass opacity (GGO) pure, mixed or solid), X-ray visibility (invisible, difficult to detect or visible), lesion size (≦10mm, 10-15mm or 15-20mm), lesion location (peripheral or middle to proximal). The yields did not show significant difference between the CT-BS 1 and CT-BS 2 of PPLs. In addition, the number of tissue samplings did not affect the diagnostic yield. No serious adverse effects occurred during and after the CT-guided bronchoscopy.
Discussion
The CT-guided bronchoscopy provided a considerably high diagnostic yield of PPLs despite the variation of lesion characteristics. Recently, it has been reported that the diagnostic yield of PPLs by EBUS-GS was 70.6%. However, the diagnostic yield was relatively low for PPLs less than 20mm in size, X-ray invisible lesion, and EBUS located adjacent to the lesion. Interestingly, the advantage of CT-guided bronchoscopy for the diagnosis of the PPLs overcomes the limitations of the EBUS-GS. The present results suggest that the CT-guided bronchoscopy showed superior diagnostic potential than EBUS-GS especially if the PPLs were small less than 20mm and X-ray invisible.
Conclusions
The diagnostic ability of CT-guided bronchoscopy is satisfied with the diagnostic yield of PPLs regardless of the variations of lesion characteristics.
|
Home
|
Inbox
|
Search
|