Guide sheath vs no guide sheath transbronchial cryobiopsy for the diagnosis of radial endobronchial ultrasound eccentric solitary pulmonary nodules

SESSION TITLE: Procedures Posters 4 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Transbronchial biopsy is an indispensable tool for the diagnosis of solitary pulmonary nodules (SPN). Its yield is however still not competitive with transparietal approach or surgical biopsy. Various methods of navigation to solitary pulmonary nodules have been developed, many of them are hindered by insufficient amount of biopsy material. It is why many centers decided to employ cryobiopsy in this process which can provide pathologist with substantial volume of tissue. METHODS: We have compared two methods of cryoprobe placement – transbronchial cryobiopsy after fluoroscopic navigation of radial endobronchial ultrasound (rEBUS) to ideal position and transbronchial cryobiopsy after guide sheath (GS) + fluoroscopic navigation to ideal position. In both groups only eccentrically visualized solitary pulmonary nodules have been utilized for statistical evaluation. Study was monocentric and retrospective evaluating 326 patients from June 2020 to February 2022. RESULTS: 329 solitary pulmonary nodules have been deemed by bronchologist as eccentrically visualized by radial endobronchial ultrasound. 212 cases in non-GS group and 117 in GS group. In all cases only transbronchial cryobiopsy was done. Morphological diagnosis was obtained in 137 patients in non-GS group (64,62%) and 88 (0,75%) (p 0,001) in GS group. CONCLUSIONS: Guide sheath based approach showed significantly higher diagnostic yield in our group of patients undergoing transbronchial cryobiopsy for solitary pulmonary nodule. CLINICAL IMPLICATIONS: GS in combination with rEBUS and cryobiopsy is effective method for diagnosing SPNs. DISCLOSURES: No relevant relationships by Lenka Navratova No relevant relationships by Zuzana Sestakova No relevant relationships by Juraj Simovic No relevant relationships by Jiri Votruba