Additional yield of transbronchial cryo-node biopsy over endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal lesions at a tertiary care center in India (COLD-FORCEPS-2 study)

Submitted: May 12, 2024
Accepted: June 3, 2024
Published: July 24, 2024
Abstract Views: 275
PDF_EARLY VIEW: 70
SUPPLEMENTARY MATERIAL: 32
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Authors

Endobronchial ultrasound (EBUS)-guided mediastinal cryobiopsy is a new modality for sampling mediastinal lymph nodes. The data regarding the diagnostic yield and utility of mediastinal cryobiopsy is still limited. Consecutive patients who were undergoing EBUS-guided transbronchial needle aspiration (EBUS-TBNA) were recruited in this study. We subjected the enrolled patients to EBUS-guided mediastinal cryobiopsy after obtaining their informed consent. The final diagnosis was made with a clinical-pathological-radiological assessment and clinical-radiological follow-up. A total of 101 patients were enrolled in the study. Adequacy in sampling achieved in EBUS-TBNA was 92.07%, compared to 98.01% achieved in EBUS-TBNA with mediastinal cryobiopsy. Diagnostic yields achieved in EBUS-TBNA and EBUS-TBNA with mediastinal cryobiopsy were 67.32% and 86.13%, respectively (p=0.001). EBUS patterns failed to predict the utility of mediastinal crobiopsy. No significant complications were observed. To conclude, EBUS-guided mediastinal cryobiopsy improves yield in patients undergoing EBUS-TBNA.

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Citations

Madan K, Mohan A, Ayub II, et al. Initial experience with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) from a tuberculosis endemic population. J Bronchology Interv Pulmonol 2014;21:208-14. DOI: https://doi.org/10.1097/LBR.0000000000000080
Lentz RJ, Argento AC, Colby TV, et al. Transbronchial cryobiopsy for diffuse parenchymal lung disease: a state-of-the-art review of procedural techniques, current evidence, and future challenges. J Thorac Dis 2017;9:2186-203. DOI: https://doi.org/10.21037/jtd.2017.06.96
Zhang J, Guo JR, Huang ZS, et al. Transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: a randomized trial. Eur Respir J 2021;58:2100055. DOI: https://doi.org/10.1183/13993003.00055-2021
Fan Y, Zhang AM, Wu XL, et al. Transbronchial needle aspiration combined with cryobiopsy in the diagnosis of mediastinal diseases: a multicentre, open-label, randomised trial. Lancet Respir Med 2023;11:256-64. DOI: https://doi.org/10.1016/S2213-2600(22)00392-7
Madan M, Mahendran AJ, Kumar R, et al. Comparative yield of transbronchial cryo-nodal biopsy, transbronchial intra-nodal forceps biopsy, and transbronchial needle aspiration for mediastinal lesions at a tertiary care center in India (COLD-FORCEPS study). Monaldi Arch Chest Dis 2024. doi: 10.4081/monaldi.2024.2813. Online ahead of print. DOI: https://doi.org/10.4081/monaldi.2024.2813
Zhang Z, Li S, Bao Y. Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy versus endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal disorders: a meta-analysis. Respiration 2024. doi: 10.1159/000538609. Online ahead of print. DOI: https://doi.org/10.1159/000538609
Cheng TL, Huang ZS, Zhang J, et al. Comparison of cryobiopsy and forceps biopsy for the diagnosis of mediastinal lesions: a randomised clinical trial. Pulmonology 2024;S2531-0437(23)00240-4. DOI: https://doi.org/10.1016/j.pulmoe.2023.12.002

Ethics Approval

Institute ethical committee clearance taken vide S. No. IEC/VMMC/SJH/Project 2024-01/429 dated 4 March 2024.

How to Cite

Madan, Manu, Rohit Kumar, Pranav Ish, Yash Kedia, AJ Mahendran, Rajnish Kaushik, Neeraj Kumar Gupta, and Nitesh Gupta. 2024. “Additional Yield of Transbronchial Cryo-Node Biopsy over Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Mediastinal Lesions at a Tertiary Care Center in India (COLD-FORCEPS-2 Study)”. Monaldi Archives for Chest Disease, July. https://doi.org/10.4081/monaldi.2024.3054.

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