ArticleJournal of thoracic disease2025
Diagnostic performance and safety of transbronchial lung cryobiopsy in the study of interstitial lung diseases: a single-center experience.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Although transbronchial lung cryobiopsy (TBLC) is gaining popularity in the diagnosis of interstitial lung disease (ILD), its diagnostic performance and safety are still a matter of debate. The objective of this study was to assess the diagnostic performance and safety of TBLC by a multidisciplinary committee (MDC). Methods: A diagnostic cross-sectional study was performed of all patients who underwent a TBLC between 2017 and 2024 in a center without previous experience in this technique. Results: A total of 117 patients undergoing a TBLC were included. A specific pathological diagnosis was achieved in 73/117 cases (62.4%) and a multidisciplinary diagnosis was obtained in 79/117 cases (67.5%). A positive result did not correlate with any variable. In total, 65 patients (55.6%) experienced a complication. Twenty-one patients had a pneumothorax (17.8%), and 11 (52.4%) needed a chest drain. The occurrence of complications was associated with age (with an inverse relationship) [odds ratio (OR), 0.920; 95% confidence interval (CI): 0.868-0.976; P=0.006] and the number of samples obtained (OR, 2.094; 95% CI: 1.111-3.947; P=0.02). Bleeding was observed in 44 cases (37.6%). Moderate (15; 12.8%) and severe (3; 2.6%) bleeding was associated with age (OR, 1.108; 95% CI: 1.021-1.202; P=0.01) and a lower number of biopsies performed (OR, 0.349; 95% CI: 0.169-0.719; P=0.004). Only a patient required mechanical ventilation. No 30-day mortality was observed. Conclusions: TBLC provides a specific diagnosis and spares a SLB in at least 2/3 of cases requiring a lung biopsy, with an acceptable incidence of pneumothorax and moderate/severe bleeding. TBLC should be further standardized to prevent inconsistencies in diagnostic performance estimates.
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