Feasibility of thin convex probe EBUS scope for the diagnosis of peripheral pulmonary lesions.

BACKGROUND AND

OBJECTIVES

Despite the emergence of advanced ancillary technologies, the transbronchial method to peripheral pulmonary lesions (PPLs) remains a challenge for bronchoscopists. The objective of the study is to assess the diagnostic value and safety of a novel thin Convex Probe Endobronchial Ultrasound (TCP-EBUS) scope in transbronchial needle aspiration (TBNA) for PPLs suspicious of malignancy.

METHODS

This single-center feasibility study prospectively enrolled patients with PPLs between August 2022 and January 2023. All lesions were biopsied by EBUS-TBNA using the novel TCP-EBUS scope (BF-UC290F, Olympus) and the prototype 22G aspiration needle (Vizishot2 22G, Olympus). The primary end point was the diagnostic yield.

RESULTS

Thirty-three subjects were evaluated, and 30 subjects were included in the final analysis. The mean patients' age was 62.4 ± 10.2 years, and 60% were male. The mean lesion size was 25.7 ± 6.8 mm, and 22 nodules were ≤30 mm. PPLs were situated adjacent to the subsegmental or sub-subsegmental bronchi (25 and 5, respectively), and the EBUS scope was advanced into segmental or subsegmental bronchi (12 and 18, respectively). Average number of punctures was 3.8 ± 1.3. Adequate specimens were obtained in all 30 (100%) of the cases. The overall diagnostic yield was 90% (27/30). No serious adverse events were observed.

CONCLUSIONS

The TCP-EBUS has decent accessibility to more distal intrapulmonary lesions. TCP-EBUS-TBNA is a safe real-time procedure with a high sensitivity for malignant PPLs in the inner two-thirds of the lung, irrespective of the presence of a bronchus sign.