Computed tomography-guided bronchoscopy in the diagnosis of small peripheral pulmonary lesions : A retrospective study of 240 examinations in a single academic center
Copyright © 2016 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved..
BACKGROUND: Factors that affect the diagnostic yield in computed tomography (CT)-guided bronchoscopy have not yet been fully evaluated. To improve the diagnostic yield of peripheral pulmonary lesions (PPLs) by CT-guided bronchoscopy, we quantitatively analyzed factors affecting the diagnostic yield.
METHODS: The data were collected for 240 PPLs in 237 patients examined by using CT-guided bronchoscopy between October 2003 and November 2011 in our respiratory center. The association of diagnostic yield with the CT bronchus sign (CT-BS), lesion size, location, number of tissue specimens, and type of bronchoscope was retrospectively assessed.
RESULTS: The diagnostic yield of PPLs with negative CT-BS was significantly lower (2.9%) than that for PPLs with positive CT-BS (52.2%; p<0.01). Among the PPLs with positive CT-BS, the yield was significantly higher in those in the left S(3) than for lesions in other bronchial segments (83.3% vs. 50.3%; p<0.05). Lesion size was not significantly associated with diagnostic yield. The yield was significantly lower in PPLs without lung tissue specimens than in lesions with biopsy specimens (p<0.01). Moreover, a thin bronchoscope produced a higher yield in comparison with other bronchoscope types (66.0% vs. 47.6%; p<0.05). Multivariate analysis revealed that the number of biopsy specimens was an independent factor affecting diagnostic yield.
CONCLUSIONS: CT-guided bronchoscopy is valuable in the diagnosis of PPLs with positive CT-BS regardless of lesion size; however, PPLs with negative CT-BS are not good candidates for CT-guided bronchoscopy. Obtaining tissue specimens by biopsy is a critical factor in diagnosing PPLs.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
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| Enthalten in: |
Respiratory investigation - 54(2016), 5 vom: 14. Sept., Seite 347-54 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tokoro, Yayoi [VerfasserIn] |
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| Links: |
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| Themen: |
Bronchoscopy |
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| Anmerkungen: |
Date Completed 27.07.2017 Date Revised 27.07.2017 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.resinv.2016.04.004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM263801721 |
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| 100 | 1 | |a Tokoro, Yayoi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Computed tomography-guided bronchoscopy in the diagnosis of small peripheral pulmonary lesions |b A retrospective study of 240 examinations in a single academic center |
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| 520 | |a Copyright © 2016 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Factors that affect the diagnostic yield in computed tomography (CT)-guided bronchoscopy have not yet been fully evaluated. To improve the diagnostic yield of peripheral pulmonary lesions (PPLs) by CT-guided bronchoscopy, we quantitatively analyzed factors affecting the diagnostic yield | ||
| 520 | |a METHODS: The data were collected for 240 PPLs in 237 patients examined by using CT-guided bronchoscopy between October 2003 and November 2011 in our respiratory center. The association of diagnostic yield with the CT bronchus sign (CT-BS), lesion size, location, number of tissue specimens, and type of bronchoscope was retrospectively assessed | ||
| 520 | |a RESULTS: The diagnostic yield of PPLs with negative CT-BS was significantly lower (2.9%) than that for PPLs with positive CT-BS (52.2%; p<0.01). Among the PPLs with positive CT-BS, the yield was significantly higher in those in the left S(3) than for lesions in other bronchial segments (83.3% vs. 50.3%; p<0.05). Lesion size was not significantly associated with diagnostic yield. The yield was significantly lower in PPLs without lung tissue specimens than in lesions with biopsy specimens (p<0.01). Moreover, a thin bronchoscope produced a higher yield in comparison with other bronchoscope types (66.0% vs. 47.6%; p<0.05). Multivariate analysis revealed that the number of biopsy specimens was an independent factor affecting diagnostic yield | ||
| 520 | |a CONCLUSIONS: CT-guided bronchoscopy is valuable in the diagnosis of PPLs with positive CT-BS regardless of lesion size; however, PPLs with negative CT-BS are not good candidates for CT-guided bronchoscopy. Obtaining tissue specimens by biopsy is a critical factor in diagnosing PPLs | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bronchoscopy | |
| 650 | 4 | |a CT-guided bronchoscopy | |
| 650 | 4 | |a CT-guided transbronchial biopsy | |
| 650 | 4 | |a Diagnostic sensitivity | |
| 650 | 4 | |a Small peripheral pulmonary lesion | |
| 700 | 1 | |a Yasuo, Masanori |e verfasserin |4 aut | |
| 700 | 1 | |a Kobayashi, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Hama, Mineyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Ichiyama, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Horiuchi, Toshimichi |e verfasserin |4 aut | |
| 700 | 1 | |a Ushiki, Atsuhito |e verfasserin |4 aut | |
| 700 | 1 | |a Kawakami, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Honda, Takayuki |e verfasserin |4 aut | |
| 700 | 1 | |a Hanaoka, Masayuki |e verfasserin |4 aut | |
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