CHEST
Original Research: Pulmonary ProceduresA Randomized Controlled Trial of a Novel Sheath Cryoprobe for Bronchoscopic Lung Biopsy in a Porcine Model
Section snippets
Materials and Methods
The present trial included a prospective, randomized, controlled, single-blinded animal study comparing three different biopsy methods (technology and technique) in lung tissue (Fig 1). The aim of the study was to evaluate the feasibility, quality, and safety of biopsy specimens obtained by using a new 1.1-mm SCBx and to compare the results with those acquired by using a 1.9-mm CBx and 2.0-mm FBx.
The study hypothesis was that the use of the new SCBx would have histopathologic accessibility
Results
Three animals were used with a mean weight of 53.2 ± 4.3 kg. In total, 44 attempts were necessary to obtain 39 (88.6%) specimens using SCBx, 53 attempts to obtain 38 (71.7%) specimens using CBx, and 40 attempts (100%) using FBx. Overall, 17.9% of the SCBx specimens, 17.14% of the CBx specimens, and 70% of the FBx specimens were too small and had to be processed as cell blocks. All other specimens were processed as paraffin blocks and stained with hematoxylin and eosin for evaluation. A simple
Discussion
Currently, the two main options for retrieving pathologic lung samples are surgical lung biopsy and bronchoscopic FBx. Due to the more invasive nature and higher cost of surgical biopsies, a bronchoscopic approach may be preferred. However, the major limitations of FBx are small biopsy specimen size and poor cellular architecture.1, 2 CBx has been shown to obtain larger biopsy samples compared with FBx.11, 12 A new technique using a novel, smaller probe with a retractable sheath (SCBx) was
Conclusions
A novel sheath CBx allowed the bronchoscope to remain within the airway during the entire procedure. SCBx was a safe technique in this animal model, and it provided a larger biopsy specimen compared with FBx, with a similar safety and histologic profile comparable to standard CBx. Human studies are warranted.
Acknowledgments
Author contributions: L. B. Y. is designated as the guarantor, taking responsibility for the integrity of the manuscript from inception to publication. All authors contributed significantly to the study design, data acquisition, analysis, writing of the manuscript, and manuscript review.
Financial/nonfinancial disclosures: None declared.
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Cited by (55)
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2023, Journal of Heart and Lung TransplantationEfficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis
2023, PulmonologyCitation Excerpt :The use of a guide sheath also needs further exploration as the use of a guide sheath was not routinely possible in most cases with the larger 1.9 mm cryoprobe, as it could hinder this procedure. The 1.1 mm cryoprobe appears an exciting addition and requires further exploration.26,27 This may allow the use of a radial EBUS in its full capacity with the maintenance of the over sheath.
Does transbronchial lung cryobiopsy improve diagnostic yield of digital tomosynthesis-assisted electromagnetic navigation guided bronchoscopic biopsy of pulmonary nodules? A pilot study
2022, Respiratory MedicineCitation Excerpt :Obtaining a larger area of tissue with preserved architecture significantly improves its diagnostic utility versus conventional forceps biopsy (FB) for both DPLD and lung tumors [12–14], although clinically relevant bleeding also increases [15]. A 1.1 mm outer diameter (OD) single use cryoprobe is now commercially available with the ERBECRYO 2 system (Erbe Medizintechnik GmbH, Tübingen, Germany) [16]. This smaller OD allows the cryoprobe to be removed through the working channel of the bronchoscope with the specimen attached, rather than having to remove the cryoprobe, tissue sample, and bronchoscope en bloc.
Diagnostic Outcomes and Safety of Cryobiopsy Added to Conventional Sampling Methods: An Observational Study
2021, ChestCitation Excerpt :Similarly, a technique should be developed that facilitates the insertion of the current cryoprobe into the upper field. A promising solution to this problem is the developed thin cryoprobes.24,36,37 The feasibility of the prototype for PPL sampling was reported in a randomized controlled trial with a crossover design, which revealed that cryobiopsy results in a higher diagnostic yield than forceps biopsy (74.2% vs 61.3%, respectively); however, the difference observed was not significant because of insufficient statistical power.24
FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.