CBCT outperforms CT‐guided transbronchial biopsy in peripheral pulmonary lesions diagnosis

Cone‐beam computed tomography (CBCT)-guided transbronchial biopsy (TBB) demonstrates better diagnostic yield and shorter examination time compared with computed tomography (CT)-guided TBB, a study has shown.

Patients with peripheral pulmonary lesions ≤30 mm were eligible for the study. Lesions whose bronchus could not be determined by CT were not included. Ultrathin bronchoscope (UTB) and biopsy forceps were advanced to the target bronchus under virtual bronchoscopic navigation (VBN), 2D-fluoroscopy, and CT or CBCT. The CT- and CBCT-guided groups were then matched for their propensity scores based on patient characteristics.

The investigators retrospectively reviewed 93 patients in the CT-guided group and 79 in the CBCT-guided group. Forty-eight distinct examination pairs were generated via propensity score matching.

In the overall diagnostic yield, better results were observed in the CBCT-guided arm than in the CT-guided arm (72.9 percent vs 47.9 percent; p=0.012). The median examination time was also significantly shorter for patients in the CBCT-guided group than those in the CT-guided group (43 [interquartile range, 37–51] vs 50 min [interquartile range, 43–62]; p=0.001).

The findings showed that diagnostic yield was better and examination time shorter with CBCT- than with CT-guided TBB.

“CBCT‐guided TBB using a UTB under VBN is a useful method for the diagnosis of peripheral small pulmonary lesions,” the investigators said. “CBCT‐guided TBB … has been used as an alternative to CT‐guided TBB.”