Late Breaking Abstract - Transbronchial lung cryobiopsy for interstitial lung disease diagnosis: results of the COLDICE Study

L. Troy, C. Grainge, T. Corte, J. Williamson, M. Vallely, W. Cooper, A. Mahar, J. Myers, Simon Lai, Ellie Mulyadi, P. Torzillo, M. Phillips, H. Jo, Susanne E Webster, Qi Lin, J. Rhodes, M. Salamonsen, J. Wrobel, B. Harris, G. Don, P. Wu, B. Ng, C. Oldmeadow, G. Raghu, E. Lau, Coldice Investigators
{"title":"Late Breaking Abstract - Transbronchial lung cryobiopsy for interstitial lung disease diagnosis: results of the COLDICE Study","authors":"L. Troy, C. Grainge, T. Corte, J. Williamson, M. Vallely, W. Cooper, A. Mahar, J. Myers, Simon Lai, Ellie Mulyadi, P. Torzillo, M. Phillips, H. Jo, Susanne E Webster, Qi Lin, J. Rhodes, M. Salamonsen, J. Wrobel, B. Harris, G. Don, P. Wu, B. Ng, C. Oldmeadow, G. Raghu, E. Lau, Coldice Investigators","doi":"10.1183/13993003.congress-2019.rct1886","DOIUrl":null,"url":null,"abstract":"Transbronchial lung cryobiopsy (TBLC) is a novel technique for sampling lung tissue for interstitial lung disease (ILD) diagnosis. Despite increasing use, the diagnostic accuracy of TBLC compared to surgical lung biopsy (SLB) remains unclear. Methods: We conducted a prospective, multicenter study investigating agreement between TBLC and SLB. ILD patients referred for lung biopsy after central screening underwent sequential TLBC and SLB, under one anesthetic. Blinded analysis of samples was conducted by 3 pathologists, individually and by consensus. At multidisciplinary discussion (MDD), deidentified cases were discussed twice with either TBLC or SLB along with clinical and radiology data, in random non-consecutive order. Primary endpoints were agreement of TBLC and SLB for 1) “definite/probable usual interstitial pneumonia (UIP)”, “indeterminate for UIP” and “alternative diagnosis” histopathologic patterns; and for 2) MDD diagnoses. Concordance and kappa values were calculated. Results: 65 patients (30 males; age 66±9yrs; FVC 84±14%; DLCO 63±13%) were enrolled. TBLC (7.1±1.9mm) and SLB samples (47±15mm) were taken from two separate ipsilateral lobes. Histopathological agreement between TBLC and SLB was 70.8%, weighted κ 0.70 (95%CI 0.55-0.86); agreement at MDD was 76.9%, κ 0.62 (95%CI 0.47-0.78). For TBLC with high/definite diagnostic confidence at MDD (39/65, 60% cases), 94.9% were concordant with SLB diagnoses. In the 26 with low-confidence/unclassifiable TBLC diagnoses, SLB reclassified only 6 to alternative high/definite MDD diagnoses. Conclusion: High agreement between TBLC and SLB for pathologic and MDD diagnoses support the clinical utility of TBLC in ILD diagnostic algorithms.","PeriodicalId":13242,"journal":{"name":"Idiopathic interstitial pneumonias","volume":"60 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Idiopathic interstitial pneumonias","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1183/13993003.congress-2019.rct1886","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 3

Abstract

Transbronchial lung cryobiopsy (TBLC) is a novel technique for sampling lung tissue for interstitial lung disease (ILD) diagnosis. Despite increasing use, the diagnostic accuracy of TBLC compared to surgical lung biopsy (SLB) remains unclear. Methods: We conducted a prospective, multicenter study investigating agreement between TBLC and SLB. ILD patients referred for lung biopsy after central screening underwent sequential TLBC and SLB, under one anesthetic. Blinded analysis of samples was conducted by 3 pathologists, individually and by consensus. At multidisciplinary discussion (MDD), deidentified cases were discussed twice with either TBLC or SLB along with clinical and radiology data, in random non-consecutive order. Primary endpoints were agreement of TBLC and SLB for 1) “definite/probable usual interstitial pneumonia (UIP)”, “indeterminate for UIP” and “alternative diagnosis” histopathologic patterns; and for 2) MDD diagnoses. Concordance and kappa values were calculated. Results: 65 patients (30 males; age 66±9yrs; FVC 84±14%; DLCO 63±13%) were enrolled. TBLC (7.1±1.9mm) and SLB samples (47±15mm) were taken from two separate ipsilateral lobes. Histopathological agreement between TBLC and SLB was 70.8%, weighted κ 0.70 (95%CI 0.55-0.86); agreement at MDD was 76.9%, κ 0.62 (95%CI 0.47-0.78). For TBLC with high/definite diagnostic confidence at MDD (39/65, 60% cases), 94.9% were concordant with SLB diagnoses. In the 26 with low-confidence/unclassifiable TBLC diagnoses, SLB reclassified only 6 to alternative high/definite MDD diagnoses. Conclusion: High agreement between TBLC and SLB for pathologic and MDD diagnoses support the clinical utility of TBLC in ILD diagnostic algorithms.
经支气管肺低温活检诊断间质性肺疾病:COLDICE研究的结果
经支气管肺低温活检(TBLC)是一种新的肺组织取样技术,用于诊断间质性肺疾病(ILD)。尽管TBLC的使用越来越多,但与外科肺活检(SLB)相比,TBLC的诊断准确性仍不清楚。方法:我们进行了一项前瞻性、多中心研究,调查TBLC和SLB之间的一致性。ILD患者在中心筛查后行序贯TLBC和SLB,在一种麻醉下进行肺活检。3名病理学家分别和一致对样本进行盲法分析。在多学科讨论(MDD)中,以随机、非连续的顺序,对未确诊病例与TBLC或SLB以及临床和放射学数据进行了两次讨论。主要终点是TBLC和SLB的一致性:1)“明确/可能的通常间质性肺炎(UIP)”,“UIP不确定”和“替代诊断”的组织病理学模式;2)重度抑郁症诊断。计算一致性和kappa值。结果:65例患者(男性30例;年龄66±9岁;FVC 84±14%;DLCO为63±13%)。TBLC(7.1±1.9mm)和SLB(47±15mm)分别取自两个同侧叶。TBLC和SLB的组织病理学一致性为70.8%,加权κ 0.70 (95%CI 0.55 ~ 0.86);MDD的一致性为76.9%,κ 0.62 (95%CI 0.47-0.78)。对于重度抑郁症高/明确诊断置信度的TBLC(39/65, 60%), 94.9%与SLB诊断一致。在26例低可信度/无法分类的TBLC诊断中,SLB仅将6例重新分类为替代性高/明确MDD诊断。结论:TBLC和SLB在病理和重度抑郁症诊断上的高度一致性支持TBLC在ILD诊断算法中的临床应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信