Bronchus sign on thin-section computed tomography is a powerful predictive factor for successful transbronchial biopsy using endobronchial ultrasound with a guide sheath for small peripheral lung lesions: a retrospective observational study

BMC Medical Imaging

Kazuyoshi Imaizumi⁴  Mitsushi Okazawa¹  Naozumi Hashimoto³  Toru Nakanishi⁴  Masaki Matsuo⁵  Sumito Isogai⁴  Masamichi Hayashi⁴  Yasuhiro Goto⁴  Sakurako Uozu⁴  Tami Hoshino⁴  Yuki Mieno⁴  Tomoko Takeyama⁴  Yoshikazu Niwa⁴  Mariko Morishita³  Teppei Yamaguchi⁴  Sayako Morikawa⁴  Naoki Yamamoto⁶  Hiroshi Yatsuya²  Takuya Okamura⁴  Tomoyuki Minezawa⁴ 

[1] Department of Respiratory Medicine, Daiyu-kai Hospital, Ichinomiya, Aichi, Japan;Department of Public Health, Fujita Health University, Toyoake, Aichi, Japan;Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan;Division of Respiratory Medicine and Clinical Allergy, Department of Internal Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan;Department of Respiratory Medicine, Chubu Rosai Hospital, Nagoya, Japan;Laboratory of Molecular Biology & Histochemistry, Fujita Health University, Toyoake, Aichi, Japan

关键词: Peripheral lung lesion;    Thin-section CT;    Diagnostic yield;    CT bronchus sign;    EBUS-GS;   

Others  :  1220824
DOI  :  10.1186/s12880-015-0060-5

 received in 2014-09-25, accepted in 2015-05-19,  发布年份 2015

【 摘 要 】

Background

Recent advances in bronchoscopy, such as transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS), have improved the diagnostic yield of small-sized peripheral lung lesions. In some cases, however, it is difficult to obtain adequate biopsy samples for pathological diagnosis. Adequate prediction of the diagnostic accuracy of TBB with EBUS-GS is important before deciding whether bronchoscopy should be performed.

Methods

We retrospectively reviewed 149 consecutive patients who underwent TBB with EBUS-GS for small-sized peripheral lung lesions (≤30 mm in diameter) from April 2012 to March 2013. We conducted an exploratory analysis to identify clinical factors that can predict an accurate diagnosis by TBB with EBUS-GS. All patients underwent thin-section chest computed tomography (CT) scans (0.5-mm slices), and the CT bronchus sign was evaluated before bronchoscopy in a group discussion. The final diagnoses were pathologically or clinically confirmed in all studied patients (malignant lesions, 110 patients; benign lesions, 39 patients).

Results

The total diagnostic yield in this study was 72.5 % (95 % confidence interval: 64.8–79.0 %). Lesion size, lesion visibility on chest X-ray, and classification of the CT bronchus sign were factors significantly associated with the definitive biopsy result in the univariate analysis. In the multivariate analysis, only the CT bronchus sign remained as a significant predictive factor for successful bronchoscopic diagnosis. The CT bronchus sign was also significantly associated with the EBUS findings of the lesions.

Conclusion

Our results suggest that the CT bronchus sign is a powerful predictive factor for successful TBB with EBUS-GS.

【 授权许可】

   
2015 Minezawa et al.

【 图 表 】

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