Diagnostic Role of Bronchoscopic Brush Biopsy Guided by Thin Section Computed Tomography in Peripheral Pulmonary Lesions

Abstract

Introduction: Pulmonary lesionsin peripheral lung are considered as peripheral pulmonary lesions (PPL). Diagnosis of PPL is important because it can be malignant nature. Diagnostic approach to PPL has limitedsensitivity in the absence of a target-guiding tool in the bronchial labyrinth. Multiplanar reconstruction images created with thin multi-slice imaging of computed tomography (CT) have started to be used as an alternative guide for bronchoscopy of PPL. In this study, we aimed to examine the diagnostic efficiency of the guidance of multiplanar reconstruction images for PPL diagnosis. Materials and Methods: Patients have PPLwhounderwent a bronchoscopic brush biopsy by gidance of multiplanar reconstruction thin images on thorax CT scans were retrospectively analyzed. The distance of the lesion to the distal bronchus, presence of bronchial association and location and size of PPL were recorded from hospital image archive system. The diagnostic rate was recorded from the procedure record unit. Results : The study was conducted with 92 cases. The mean size of PPL was 40 ± 21 mm, and the average distal bronchial lesion distance was 27 ± 19 mm. Bronchial association was found in 49 (53.3%) patients. The diagnostic yield of the method was 48.9%. Diagnostic rate in patients with bronchial association (67.3%) was found to be significantly higher than those without (26.7%) (p = 0.001). In logistic regression analysis, the factors affecting the diagnosis were distal bronchial lesion distance, presence of bronchial association and localization of the lesion. Conclusion: The guidance of thin multi-slice CT reconstruction images for PPL diagnosis can be easily performed in patients with PPL that over 20 mm and have bronchial association in centers where there is no interventional radiology unit and other guidance tools.