Factors associated with the diagnostic yield of computed tomography-guided transbronchial lung biopsy

BackgroundComputed tomography (CT) may be useful for increasing the diagnostic yield of transbronchial lung biopsy (TBLB). However, only a few studies with small sample sizes have reported the diagnostic utility of CT-guided TBLB and the factors affecting the diagnostic accuracy of CT-guided TBLB are not well known. We evaluated the diagnostic yield of CT-guided TBLB and associated factors. Methods CT-guided TBLB was performed in 59 patients. Both conventional fluoroscopy and CT were used in all patients for TBLB. The biopsy forceps were advanced toward the lesion under conventional fluoroscopic guidance. CT was used to check whether the forceps were in the correct position. ResultsThe average diameter of the lesions was 3.11.0cm. The biopsy forceps correctly reached the lesion in 43 patients by real-time CT. A diagnosis was made in 42 patients, and the overall diagnostic yield was 71.2%. The sensitivity for malignancy was 85.7%. In multivariate analysis, the only factor associated with diagnostic yield was forceps position assessed by CT scan (adjusted odds ratio 53.31; 95% confidence interval 5.31, 535.27; P=0.001). Conclusion CT-guided TBLB is a useful diagnostic tool for pulmonary nodules or masses. The correct positioning of biopsy forceps using CT is valuable for successful CT-guided TBLB.