@article {TomassettiP2306, author = {Sara Tomassetti and Athol U. Wells and Ulrich Costabel and Cavazza Alberto and Thomas V. Colby and Rossi Giulio and Carloni Angelo and Sverzellati Nicola and Jay H. Ryu and Matteo Buccioli and Paola Tantalocco and Oriana Nanni and Elisa Carretta and Claudia Ravaglia and Christian Gurioli and Gian Luca Casoni and Carlo Gurioli and Micaela Romagnoli and Alessandra Dubini and Chilosi Marco and Venerino Poletti}, title = {The diagnostic role of cryobiopsy in the multidisciplinary diagnosis of idiopathic pulmonary fibrosis}, volume = {42}, number = {Suppl 57}, elocation-id = {P2306}, year = {2013}, publisher = {European Respiratory Society}, abstract = {OBJECTIVEThe objective of this study is to address the diagnostic role of cryobiopsy in the multidisciplinary diagnosis (MDD) of idiophatic pulmonary fibrosis (IPF) compared to surgical lung biopsy (SLB).METHODWe evaluated 117 consecutive cases of fibrotic ILDs. 59 (50\%) underwent SLB and a 58 (50\%) cryobiopsies. Two clinicians (AUW and UC), two radiologists (AC and NS) and two pathologists (AC and GR) sequentially reviewed clinical-radiological findings and biopsies, recording at each step their diagnostic impression.RESULTSBiopsies were diagnostic in 55 cryobiopsy (93\%), and in all but one SLB (98\%).UIP pattern was detected with a high confidence level in 51\% (20/39) and 84\% (32/38) of cryobiopsy and SLB respectively. Kappa coefficient of agreement between pathologists was 0.73, 95\% CI 0.54-0.91 and 0.83, 95\% CI 0.69-0.99 for cryobiopsy and SLB respectively.The multidisciplinary team of experts changed the initial consensus diagnostic impression after SLB and cryobiopsy in 38 cases (64.4\%) and 39 cases (67.2\%) respectively (p=0.747). Unanimous agreement between experts in diagnosis of IPF with high level of confidence changed from 3.5\% (2/58) to 17\% (10/58) before and after cryobiopsy, respectively. Similarly in SLB changed from 3.4\% (2/59) to 20\% (12/59).90 days mortality related to cryobiopsy was 1.7\% compared to 3.4\% for SLB.CONCLUSIONPathologists are less confident in the recognition of UIP pattern on cryobiopsy compared to SLB. However in the context of MDD the impact of cryobiopsy and SLB in the diagnosis of IPF is strikingly similar. Given the higher mortality of SLB, we conclude that transbronchial cryobiopsy could replace SLB in the evaluation of suspected IPF.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/42/Suppl_57/P2306}, eprint = {https://erj.ersjournals.com/content/42/Suppl_57/P2306.full.pdf}, journal = {European Respiratory Journal} }