大工作通道直径超薄支气管镜在锥形束ct引导下经支气管活检诊断肺周围病变中的优势

IF 4.5 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2025-03-05 DOI:10.1016/j.lungcan.2025.108483

Naoya Kawakita , Emi Takehara , Taihei Takeuchi , Keisuke Fujimoto , Shinichi Sakamoto , Hiroyuki Sumitomo , Naoki Miyamoto , Atsushi Morishita , Hiroaki Toba , Hiromitsu Takizawa

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引用次数: 0

摘要

背景与目的在虚拟支气管镜导航（VBN）下，利用超薄支气管镜（UTB）进行单束计算机断层扫描（CBCT）引导下的经支气管活检（TBB）是诊断周围性肺病变的一种有效方法。可提供1.2 mm工作通道UTB （SC-UTB）和1.7 mm工作通道UTB (LC-UTB)，后者允许径向支气管内超声（R-EBUS）。本研究的目的是比较使用SC-UTB和LC-UTB与R-EBUS的cbct引导下VBN下TBB的诊断率。方法纳入肺周围病变≤30 mm的患者。排除CT扫描上无法识别的支气管病变。在VBN和2d透视下将UTB和活检钳推进到目标支气管。对于使用SC-UTB的病例，在插入镊子的情况下进行CBCT。在使用LC-UTB的病例中，在插入R-EBUS探针后插入钳进行CBCT。比较两组的结果。结果89例患者采用sc - utb， 68例患者采用LC-UTB联合R-EBUS。SC-UTB和LC-UTB联合R-EBUS的诊断率分别为64.0%和79.4%，后者的诊断率显著高于后者（p = 0.036）。此外，初级CBCT上1型图像的比例（钳尖在病变内）显着增加(31.5% vs 50.0%；p = 0.019)，初次CBCT后再导航的比例下降(47.5% vs. 20.6%；p = 0.001)，在LC-UTB与R-EBUS组。结论在cbct引导下使用UTB对周围性肺病变进行TBB时，LC-UTB联合R-EBUS比SC-UTB的诊断率更高。会议演示：无。

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Advantages of a larger working channel diameter of ultrathin bronchoscope in cone-beam computed tomography-guided transbronchial biopsy for diagnosing peripheral lung lesions

Background and objective

Cone-beam computed tomography (CBCT)-guided transbronchial biopsy (TBB) using an ultrathin bronchoscope (UTB) under virtual bronchoscopic navigation (VBN) is a useful method for diagnosing peripheral pulmonary lesions. A 1.2 mm working channel UTB (SC-UTB) and a 1.7 mm working channel UTB (LC-UTB) are available, with the latter allowing radial endobronchial ultrasound (R-EBUS). The aim of this study was to compare the diagnostic yield of CBCT-guided TBB under VBN using SC-UTB and LC-UTB with R-EBUS.

Methods

Patients with peripheral pulmonary lesions of ≤ 30 mm were included. Lesions with unidentifiable bronchi on CT scans were excluded. The UTB and biopsy forceps were advanced to the target bronchus under VBN and 2D-fluoroscopy. For cases using SC-UTB, CBCT was performed with forceps inserted. In cases using LC-UTB, CBCT was performed with forceps inserted after inserting the R-EBUS probe. The outcomes were compared between the two groups.

Results

SC-UTB was used in 89 patients, and LC-UTB with R-EBUS in 68 patients. The diagnostic yield was 64.0 % and 79.4 % in cases using SC-UTB and LC-UTB with R-EBUS, respectively, showing a significantly higher diagnostic yield with the latter (p = 0.036). Additionally, the proportion of type 1 images on the primary CBCT (forceps tip within the lesion) significantly increased (31.5 % vs. 50.0 %; p = 0.019), and the proportion of re-navigation after the primary CBCT decreased (47.5 % vs. 20.6 %; p = 0.001) in the LC-UTB with R-EBUS group.

Conclusion

In CBCT-guided TBB using UTB for peripheral pulmonary lesions, LC-UTB with R-EBUS demonstrated a higher diagnostic yield compared to SC-UTB.

Conference presentation: none.

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.