Ultrathin bronchoscopic cryobiopsy safe, effective in probe of peripheral pulmonary lesions

The feasibility of ultrathin bronchoscopic cryobiopsy has been proven recently in a study, which also demonstrates its effectiveness and safety for the diagnosis of peripheral pulmonary lesions.

A team of investigators enrolled 50 patients with peripheral pulmonary lesions ≤30 mm in diameter in this study. All participants underwent forceps biopsy, followed by cryobiopsy using a 3.0-mm ultrathin bronchoscope under radial probe endobronchial ultrasound guidance, virtual bronchoscopic navigation, and fluoroscopic guidance. The feasibility of this procedure was the primary endpoint.

On computed tomography, the median longest diameter of lesions was 17.9 mm. Of the patients, 49 (98 percent) had a successful cryobiopsy.

A specific diagnosis was provided by forceps biopsy in 27 patients (54 percent), cryobiopsy in 31 (62 percent), and the combination of these two methods in 37 (74 percent). The median size of specimens obtained through cryobiopsy were significantly larger than that obtained via forceps biopsy (7.0 vs 1.2 mm²; p<0.001).

In terms of adverse events, mild bleeding occurred in 47 patients (94 percent) during cryobiopsy, but moderate or severe bleeding and pneumothorax did not.

Ultrathin bronchoscopy helps clinicians in detecting peripheral pulmonary lesions, but both the working channel and the specimens are small.

“A 1.1-mm ultrathin cryoprobe that can enter the working channel of the ultrathin bronchoscope is now available, which may overcome the limitations of small specimen size,” the investigators said.