Comparative effectiveness of radial probe endobronchial ultrasound versus CT-guided needle biopsy for evaluation of peripheral pulmonary lesions: A randomized pragmatic trial

Summary In many patients the optimal method of investigation of peripheral pulmonary lesions (PPL) is not clear. We performed a prospective randomized pragmatic trial to determine the comparative effectiveness of endobronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) and CT-guided pe...

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Bibliographic Details
Published in:Respiratory medicine 2011-11, Vol.105 (11), p.1704-1711
Main Authors: Steinfort, Daniel P, Vincent, Janette, Heinze, Stefan, Antippa, Phillip, Irving, Louis B
Format: Article
Language:English
Subjects:
Accuracy
Adenocarcinoma, Bronchiolo-Alveolar - diagnostic imaging
Adenocarcinoma, Bronchiolo-Alveolar - pathology
Aged
Biological and medical sciences
Biopsy
Biopsy, Needle - instrumentation
Biopsy, Needle - methods
Bronchoscopy
Bronchoscopy - instrumentation
Clinical trials
Cost-benefit analysis
Decision Making
Diagnostic accuracy
Endosonography - instrumentation
Female
Humans
Lung
Lung cancer
Lung Neoplasms - diagnostic imaging
Lung Neoplasms - pathology
Male
Medical diagnosis
Medical sciences
Neoplasms, Squamous Cell - diagnostic imaging
Neoplasms, Squamous Cell - pathology
Non-inferiority
Pneumology
Pneumothorax
Probes
Prospective Studies
Pulmonary/Respiratory
Respiratory system : syndromes and miscellaneous diseases
Sensitivity and Specificity
Teaching hospitals
Tomography, X-Ray Computed
Tumors of the respiratory system and mediastinum
Ultrasound
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Summary:Summary In many patients the optimal method of investigation of peripheral pulmonary lesions (PPL) is not clear. We performed a prospective randomized pragmatic trial to determine the comparative effectiveness of endobronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) and CT-guided percutaneous needle biopsy (CT-PNB) for the investigation of PPL. Overall complication rates were higher in those undergoing CT-PNB (27% v 3%, p  = 0.03), while diagnostic accuracy of EBUS-TBLB was shown to be non-inferior to that of CT-PNB. Expected diagnostic accuracy and complication rates are likely to differ for individual patients on the basis of specific complex clinicoradiologic factors, which will influence the cost-benefit analysis between EBUS-TBLB and CT-PNB for individual patients. Further studies are required to examine the effect of these factors on clinical decision-making.
ISSN:0954-6111
1532-3064
DOI:10.1016/j.rmed.2011.08.008