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Transbronchial Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: CHEST Guideline and Expert Panel Report.

Publication ,  Journal Article
Maldonado, F; Danoff, SK; Wells, AU; Colby, TV; Ryu, JH; Liberman, M; Wahidi, MM; Frazer, L; Hetzel, J; Rickman, OB; Herth, FJF; Poletti, V ...
Published in: Chest
April 2020

BACKGROUND: Transbronchial cryobiopsy (TBC) is increasingly recognized as a potential alternative to surgical lung biopsy (SLB) for the diagnosis of interstitial lung disease (ILD). The goal of this analysis was to examine the literature on TBC as it relates to diagnostic utility and safety to provide evidence-based and expert guidance to clinicians. METHODS: Approved panelists developed key questions regarding the diagnostic utility and safety of TBC for the evaluation of ILD using the PICO (Population, Intervention, Comparator, Outcome) format. MEDLINE (via PubMed) and the Cochrane Library were systematically searched for relevant literature, which was supplemented by manual searches. References were screened for inclusion, and vetted evaluation tools were used to assess the quality of included studies, to extract data, and to grade the level of evidence supporting each recommendation or statement. Graded recommendations and ungraded consensus-based statements were drafted and voted on using a modified Delphi technique to achieve consensus. RESULTS: The systematic review and critical analysis of the literature based on four PICO questions resulted in six statements: two evidence-based graded recommendations and four ungraded consensus-based statements. CONCLUSIONS: Evidence of the utility and safety of TBC for the diagnosis of ILD is limited but suggests TBC is safer than SLB, and its contribution to the diagnosis obtained via multidisciplinary discussion is comparable to that of SLB, although the histological diagnostic yield appears higher with SLB (approximately 80% for TBC vs 95% for SLB). Additional research is needed to enhance knowledge regarding utility and safety of TBC, its role in the diagnostic algorithm of ILD, and the impact of technical aspects of the procedure on diagnostic yield and safety.

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Published In

Chest

DOI

EISSN

1931-3543

Publication Date

April 2020

Volume

157

Issue

4

Start / End Page

1030 / 1042

Location

United States

Related Subject Headings

  • Safety Management
  • Respiratory System
  • Procedures and Techniques Utilization
  • Lung Diseases, Interstitial
  • Humans
  • Cryosurgery
  • Bronchoscopy
  • Biopsy
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Maldonado, F., Danoff, S. K., Wells, A. U., Colby, T. V., Ryu, J. H., Liberman, M., … Yarmus, L. B. (2020). Transbronchial Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: CHEST Guideline and Expert Panel Report. Chest, 157(4), 1030–1042. https://doi.org/10.1016/j.chest.2019.10.048
Maldonado, Fabien, Sonye K. Danoff, Athol U. Wells, Thomas V. Colby, Jay H. Ryu, Moishe Liberman, Momen M. Wahidi, et al. “Transbronchial Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: CHEST Guideline and Expert Panel Report.Chest 157, no. 4 (April 2020): 1030–42. https://doi.org/10.1016/j.chest.2019.10.048.
Maldonado F, Danoff SK, Wells AU, Colby TV, Ryu JH, Liberman M, et al. Transbronchial Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: CHEST Guideline and Expert Panel Report. Chest. 2020 Apr;157(4):1030–42.
Maldonado, Fabien, et al. “Transbronchial Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: CHEST Guideline and Expert Panel Report.Chest, vol. 157, no. 4, Apr. 2020, pp. 1030–42. Pubmed, doi:10.1016/j.chest.2019.10.048.
Maldonado F, Danoff SK, Wells AU, Colby TV, Ryu JH, Liberman M, Wahidi MM, Frazer L, Hetzel J, Rickman OB, Herth FJF, Poletti V, Yarmus LB. Transbronchial Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: CHEST Guideline and Expert Panel Report. Chest. 2020 Apr;157(4):1030–1042.

Published In

Chest

DOI

EISSN

1931-3543

Publication Date

April 2020

Volume

157

Issue

4

Start / End Page

1030 / 1042

Location

United States

Related Subject Headings

  • Safety Management
  • Respiratory System
  • Procedures and Techniques Utilization
  • Lung Diseases, Interstitial
  • Humans
  • Cryosurgery
  • Bronchoscopy
  • Biopsy
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology