CHEST Guidelines-Diagnostic-Outcomes-and-Safety-of-Cryobiopsy-Added

Diagnostic-Outcomes-and-Safety-of-Cryobiopsy-Added

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The observational study by Matsumoto et al. examined the impact of cryobiopsy on the diagnostic yield and safety when combined with conventional biopsy methods for peripheral pulmonary lesions (PPLs). Conducted at the National Cancer Center Hospital in Tokyo, the study retrospectively analyzed 257 patients from June 2017 to May 2018 who underwent cryobiopsy alongside traditional techniques such as forceps, brushes, and aspiration needles.<br /><br />Results indicated an overall diagnostic yield of 89.9%, with cryobiopsy alone diagnosing 22 lesions that conventional methods did not, thereby increasing the diagnostic rate by 8.6%. The combination was particularly effective when lesions were near areas assessed through radial endobronchial ultrasound. Factors like bronchus sign positivity, location in the right upper or left upper segment lobes, and visibility on radiographs significantly influenced diagnostic outcomes. However, the procedure was not without risks; severe hemorrhage occurred in three cases (1.2%), pneumothorax in two (0.8%), and two patients required hospitalization due to cerebral infarction and lung abscess.<br /><br />This study highlights the enhanced diagnostic yield provided by cryobiopsy, especially for difficult-to-diagnose lesions adjacent to bronchial structures, while also underscoring the need for caution due to potential complications. The findings suggest cryobiopsy is a valuable tool when used in conjunction with conventional methods, although further technique refinement is necessary to minimize risks. Future improvements may include new cryoprobe designs and integration with imaging advancements like cone-beam CT to enhance safety and efficacy.

Keywords

cryobiopsy

diagnostic yield

peripheral pulmonary lesions

conventional biopsy methods

National Cancer Center Hospital

radial endobronchial ultrasound

bronchus sign

hemorrhage

pneumothorax

cone-beam CT