https://doi.org/10.4081/monaldi.2024.3140
Comparison of diagnostic yield and safety of endobronchial ultrasound-guided mediastinal lymph nodal cryobiopsy and endobronchial ultrasound-guided Franseen tip needle biopsy
Submitted: July 18, 2024
Accepted: September 27, 2024
Published: December 6, 2024
Accepted: September 27, 2024
Abstract Views: 375
PDF_EARLY VIEW: 122
SUPPLEMENTARY MATERIAL: 10
SUPPLEMENTARY MATERIAL: 10
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
In this prospective study, we evaluated the diagnostic yield and safety of two endobronchial ultrasound (EBUS) biopsy techniques – mediastinal cryobiopsy (EBUS-MCB) and Franseen tip needle biopsy (EBUS-ANB) – in patients with undiagnosed mediastinal lymphadenopathy. The study included 30 patients who underwent both EBUS-MCB and EBUS-ANB, with four biopsies taken from each patient using both methods. The results demonstrated that EBUS-MCB provided a higher diagnostic yield (96.4%) compared to EBUS-ANB (73.3%). Specimens from EBUS-MCB showed fewer artifacts and a higher density of granulomas and were adequate for ancillary studies in all cases. The most common complication observed was minor bleeding, which was more common with EBUS-MCB (36.6% versus 13.3%, p=0.04). This study demonstrates that EBUS-guided cryobiopsy has a higher diagnostic yield when compared to EBUS-guided Franseen tip needle biopsy and that both biopsy techniques have an acceptable safety profile. Larger studies comparing these two techniques are necessary to confirm the findings of the current study.
Agarwal R, Srinivasan A, Aggarwal AN, Gupta D. Efficacy and safety of convex probe EBUS-TBNA in sarcoidosis: a systematic review and meta-analysis. Respir Med 2012;106:883-92.
DOI: https://doi.org/10.1016/j.rmed.2012.02.014
Yang B, Li F, Shi W, et al. Endobronchial ultrasound-guided transbronchial needle biopsy for the diagnosis of intrathoracic lymph node metastases from extrathoracic malignancies: a meta-analysis and systematic review. Respirology 2014;19:834-41.
DOI: https://doi.org/10.1111/resp.12335
Ye W, Zhang R, Xu X, et al. Diagnostic efficacy and safety of endobronchial ultrasound-guided transbronchial needle aspiration in intrathoracic tuberculosis: a meta-analysis. J Ultrasound Med 2015;34:1645-50.
DOI: https://doi.org/10.7863/ultra.15.14.06017
Labarca G, Sierra-Ruiz M, Kheir F, et al. Diagnostic accuracy of endobronchial ultrasound transbronchial needle aspiration in lymphoma. a systematic review and meta-analysis. Ann Am Thorac Soc 2019;16:1432-9.
DOI: https://doi.org/10.1513/AnnalsATS.201902-175OC
Uchimura K, Yanase K, Imabayashi T, et al. The impact of core tissues on successful next-generation sequencing analysis of specimens obtained through endobronchial ultrasound-guided transbronchial needle aspiration. Cancers 2021;13:5879.
DOI: https://doi.org/10.3390/cancers13235879
Balwan A, Bixby B, Grotepas C, et al. Core needle biopsy with endobronchial ultrasonography: single center experience with 100 cases. J Am Soc Cytopathol 2020;9:249-53.
DOI: https://doi.org/10.1016/j.jasc.2020.04.009
Cheng G, Mahajan A, Oh S, et al. Endobronchial ultrasound-guided intranodal forceps biopsy (EBUS-IFB)-technical review. J Thorac Dis 2019;11:4049-58.
DOI: https://doi.org/10.21037/jtd.2019.08.106
Zhang J, Guo JR, Huang ZS, et al. Transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: a randomised trial. Eur Respir J 2021;58:2100055.
DOI: https://doi.org/10.1183/13993003.00055-2021
Agrawal A, Ghori U, Chaddha U, Murgu S. Combined EBUS-IFB and EBUS-TBNA vs EBUS-TBNA alone for intrathoracic adenopathy: a meta-analysis. Ann Thorac Surg 2022;114:340-8.
DOI: https://doi.org/10.1016/j.athoracsur.2020.12.049
Oezkan F, Byun WY, Loeffler C, et al. Crown-cut endobronchial ultrasound guided transbronchial aspiration needle: first real-world experiences. J Clin Med 2021;11:163.
DOI: https://doi.org/10.3390/jcm11010163
Botana-Rial M, Lojo-Rodríguez I, Leiro-Fernández V, et al. Is the diagnostic yield of mediastinal lymph node cryobiopsy (cryoEBUS) better for diagnosing mediastinal node involvement compared to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)? A systematic review. Respir Med 2023;218:107389.
DOI: https://doi.org/10.1016/j.rmed.2023.107389
Madan M, Kumar R, Ish P, et al. 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 Arch Chest Dis 2024. doi: 10.4081/monaldi.2024.3054.
DOI: https://doi.org/10.4081/monaldi.2024.3054
Maturu VN, Prasad VP, Vaddepally CR, et al. Endobronchial ultrasound-guided mediastinal lymph nodal cryobiopsy in patients with nondiagnostic/inadequate rapid on-site evaluation: a new step in the diagnostic algorithm. J Bronchology Interv Pulmonol 2024;31:2-12.
DOI: https://doi.org/10.1097/LBR.0000000000000913
Mehta RM, Aurangabadbadwalla R, Singla A, et al. Endobronchial ultrasound-guided mediastinal lymph node forceps biopsy in patients with negative rapid-on-site-evaluation: A new step in the diagnostic algorithm. Clin Respir J 2020;14:314-9.
DOI: https://doi.org/10.1111/crj.13133
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;30:466-74.
DOI: https://doi.org/10.1016/j.pulmoe.2023.12.002
Dhooria S, Sehgal IS, Prasad KT, et al. Diagnostic yield and safety of the ProCore versus the standard EBUS-TBNA needle in subjects with suspected sarcoidosis. Expert Rev Med Devices 2021;18:211-6.
DOI: https://doi.org/10.1080/17434440.2021.1876560
McCracken DJ, Bailey M, McDermott MT, et al. A retrospective analysis comparing the use of ProCore® with standard fine needle aspiration in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Ir J Med Sci 2019;188:85-8.
DOI: https://doi.org/10.1007/s11845-018-1816-z
Lim CE, Steinfort DP, Irving LB. Diagnostic performance of 19-gauge endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in suspected lymphoma: a prospective cohort study. Clin Respir J 2020;14:800-5.
DOI: https://doi.org/10.1111/crj.13198
Oikonomidou R, Petridis D, Alexidis P, et al. "One Shot" Sample Evaluation of 22G, 22G upgraded, 21G and 19G needle for Endobronchial Ultrasound-EBUS-TBNA. J Cancer 2022;13:2982-7.
DOI: https://doi.org/10.7150/jca.74022
Mohan BP, Shakhatreh M, Garg R, et al. Comparison of Franseen and fork-tip needles for EUS-guided fine-needle biopsy of solid mass lesions: a systematic review and meta-analysis. Endosc Ultrasound 2019;8:382-91.
DOI: https://doi.org/10.4103/eus.eus_27_19
Chong CC, Pittayanon R, Pausawasdi N, et al. Consensus statements on endoscopic ultrasound-guided tissue acquisition. Guidelines from the Asian Endoscopic Ultrasound Group. Dig Endosc 2024;36:871-83.
DOI: https://doi.org/10.1111/den.14768
Kramer T, Kuijvenhoven JC, von der Thüsen J, et al. Endobronchial ultrasound in diagnosing and staging of lung cancer by Acquire 22G TBNB versus regular 22G TBNA needles: a randomized clinical trial. Lung Cancer 2023;185:107362.
DOI: https://doi.org/10.1016/j.lungcan.2023.107362
Brown MV, Lavrencic K, Badiei A, et al. First Asia-Pacific experience of trans-bronchial core biopsy with a Franseen needle. J Thorac Dis 2023;15:3273-84.
DOI: https://doi.org/10.21037/jtd-22-1747
Aboudara MC, Saettele T, Tawfik O. Endobronchial ultrasound bronchoscopy Franseen fine needle biopsy tool versus standard fine needle aspiration needle: Impact on diagnosis and tissue adequacy. Respir Med 2023;208:107131.
DOI: https://doi.org/10.1016/j.rmed.2023.107131
Wälscher J, Büscher E, Bonella F, et al. Comparison of a 22G crown-cut needle with a conventional 22G needle with EBUS guidance in diagnosis of sarcoidosis. Lung 2022;200:633-41.
DOI: https://doi.org/10.1007/s00408-022-00562-x
Zhang J, Fu WL, Huang ZS, et al. Primary Mediastinal seminoma achieved by transbronchial mediastinal cryobiopsy. Respiration 2020;99:426-30.
DOI: https://doi.org/10.1159/000505936
Ramarmuty HY, Huan NC, Nyanti LE, et al. Early experience of endobronchial ultrasound-guided transbronchial nodal cryobiopsy: a case series from Sabah, Malaysia. Ther Adv Respir Dis 2024;18:17534666241231122.
DOI: https://doi.org/10.1177/17534666241231122
Gershman E, Ikan AA, Pertzov B, et al., Mediastinal "deep freeze"-transcarinal lymph node cryobiopsy. Thorac Cancer 2022;13:1592-6.
DOI: https://doi.org/10.1111/1759-7714.14422
Ariza-Prota M, Pérez-Pallarés J, Fernández-Fernández A, et al. Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: safety, feasibility and diagnostic yield - experience in 50 cases. ERJ Open Res; 2023:9:00448-2022.
DOI: https://doi.org/10.1183/23120541.00448-2022
Poletti V, Petrarulo S, Piciucci S, et al. EBUS-guided cryobiopsy in the diagnosis of thoracic disorders. Pulmonology 2024;30:459-65.
DOI: https://doi.org/10.1016/j.pulmoe.2023.11.008
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
Ramarmuty HY, Oki M. Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy: a narrative review. Mediastinum 2023;8:2.
DOI: https://doi.org/10.21037/med-23-34
Ethics Approval
The study protocol was approved by the Ethical Review Committee of Yashoda Super Specialty Hospitals (IRB No: RP/01/2023) on 18/01/2023.How to Cite
Maturu, Venkata Nagarjuna, Anand Vijay, Virender Pratibh Prasad, Rinoosha Rechal, Vipul Kumar Garg, and Shweta Sethi. 2024. “Comparison of Diagnostic Yield and Safety of Endobronchial Ultrasound-Guided Mediastinal Lymph Nodal Cryobiopsy and Endobronchial Ultrasound-Guided Franseen Tip Needle Biopsy”. Monaldi Archives for Chest Disease, December. https://doi.org/10.4081/monaldi.2024.3140.
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