TY - JOUR T1 - Ultrasound guided transbronchial cryobiopsy in the diagnosis of peripheral lung lesions: A feasibility and safety trial JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - 4525 AU - Ralf Eberhardt AU - Maren Schuhmann AU - Korkut Bostanci AU - Nicolas Kahn AU - Philipp A. Schnabel AU - Felix J.F. Herth Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/4525.abstract N2 - Background: Peripheral lung lesions (PLL) can pose a diagnostic problem since they are often difficult to reach and only insufficient material can be obtained by transbronchial forceps biopsy. Endobronchial Ultrasound (EBUS) can be used for detection of PLL and in combination with a flexible cryoprobe (Erbe Medizintechnik, Germany) larger tissue samples can be taken. The purpose of this study was to evaluate the safety and feasibility of this technique.Methods: Patients with PPL up to 4cm in diameter were enrolled prospectively. After the PLL had been identified by EBUS we performed forceps as well as cryo biopsies under fluoroscopy through a guide-sheath. The order of the techniques used was randomised. The pathologist was blinded towards the biopsy technique. We evaluated and compared the diagnostic yield and sample size as well as the complication rate.Results: We were able to reach the lesion with EBUS guidance in 31 of 39 patients. The final diagnosis of the 31 patients was malignant in 25 and benign in 6 cases. In 74% we were able to make a definitive diagnosis with bronchoscopic sampling (23 of 31). In 19 cases the diagnosis was made with forceps as well as cryobiopsy, in 4 cases only through cryobiopsy. Samples obtained by cryobiposy were significantly larger. Complications observed during the procedure were 1 moderate bleed after cryobiopsy treated endoscopically. No pneumthorax occurred.Discussion: Transbronchial cryobiopsy with EBUS guidance is a safe technique and useful to obtain histological samples for diagnostic purposes. By obtaining larger tissue samples it may be possible to improve the bronchoscopic diagnostic yield for peripheral lung lesions. ER -