Comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal and hilar lesions: a prospective observational study
Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and widely used technique for diagnosing mediastinal/hilar lesions. Recent studies showed that combining EBUS-TBNA with cryobiopsy (EBUS-transbronchial mediastinal cryobiopsy, EBUS-TMC) or forceps biops...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2550581 |
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| author | Ching-Kai Lin Sheng-Yuan Ruan Hung-Jen Fan Hao-Chun Chang Yen-Ting Lin Chao-Chi Ho |
| author_facet | Ching-Kai Lin Sheng-Yuan Ruan Hung-Jen Fan Hao-Chun Chang Yen-Ting Lin Chao-Chi Ho |
| author_sort | Ching-Kai Lin |
| collection | DOAJ |
| description | Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and widely used technique for diagnosing mediastinal/hilar lesions. Recent studies showed that combining EBUS-TBNA with cryobiopsy (EBUS-transbronchial mediastinal cryobiopsy, EBUS-TMC) or forceps biopsy (EBUS-intranodal forceps biopsy, EBUS-IFB) enhances diagnostic accuracy by obtaining larger tissue samples. However, limited data is comparing the efficacy of EBUS-TMC and EBUS-IFB. This study aims to assess the effectiveness of these biopsy techniques in diagnosing mediastinal and hilar lesions.Methods Patients with mediastinal/hilar lesions who underwent EBUS-TBNA and mediastinal biopsy from November 2022 to March 2024 were enrolled. Following needle aspiration, cryobiopsy and forceps biopsies were performed. The primary endpoint was diagnostic accuracy.Results A total of 219 mediastinal/hilar lesions were evaluated in 183 patients. EBUS-TMC demonstrated higher diagnostic accuracy than EBUS-IFB (95.4% vs. 84.9%, p < 0.001). Subgroup analysis also showed superior yield rates for EBUS-TMC (96.1% vs. 89.6%, p = 0.027 in all malignancies; 96.1% vs. 86.8%, p = 0.042 in malignancies for re-biopsy; 95.2% vs. 76.2%, p = 0.040 in non-lung cancer malignancies; 93.8% vs. 73.8%, p = 0.002 in benign processes). The tissue specimens obtained via EBUS-TMC were significantly larger than those via EBUS-IFB (16.3 mm2 vs. 3.1 mm2, p < 0.001). Adding EBUS-IFB did not improve accuracy when EBUS-TMC was already used with EBUS-TBNA. No severe complications leading to death or disability were observed.Conclusions EBUS-TMC is an effective diagnostic and auxiliary method for mediastinal/hilar lesions, enhancing yield rates and tissue acquisition. |
| format | Article |
| id | doaj-art-73e41b21c81c47c1b0ac8ff396a92b5d |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
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| series | Annals of Medicine |
| spelling | doaj-art-73e41b21c81c47c1b0ac8ff396a92b5d2025-08-26T04:23:12ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2550581Comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal and hilar lesions: a prospective observational studyChing-Kai Lin0Sheng-Yuan Ruan1Hung-Jen Fan2Hao-Chun Chang3Yen-Ting Lin4Chao-Chi Ho5Department of Medicine, National Taiwan University Cancer Center, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Medicine, National Taiwan University Cancer Center, Taipei, TaiwanDepartment of Medicine, National Taiwan University Cancer Center, Taipei, TaiwanDepartment of Medicine, National Taiwan University Cancer Center, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanBackground Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and widely used technique for diagnosing mediastinal/hilar lesions. Recent studies showed that combining EBUS-TBNA with cryobiopsy (EBUS-transbronchial mediastinal cryobiopsy, EBUS-TMC) or forceps biopsy (EBUS-intranodal forceps biopsy, EBUS-IFB) enhances diagnostic accuracy by obtaining larger tissue samples. However, limited data is comparing the efficacy of EBUS-TMC and EBUS-IFB. This study aims to assess the effectiveness of these biopsy techniques in diagnosing mediastinal and hilar lesions.Methods Patients with mediastinal/hilar lesions who underwent EBUS-TBNA and mediastinal biopsy from November 2022 to March 2024 were enrolled. Following needle aspiration, cryobiopsy and forceps biopsies were performed. The primary endpoint was diagnostic accuracy.Results A total of 219 mediastinal/hilar lesions were evaluated in 183 patients. EBUS-TMC demonstrated higher diagnostic accuracy than EBUS-IFB (95.4% vs. 84.9%, p < 0.001). Subgroup analysis also showed superior yield rates for EBUS-TMC (96.1% vs. 89.6%, p = 0.027 in all malignancies; 96.1% vs. 86.8%, p = 0.042 in malignancies for re-biopsy; 95.2% vs. 76.2%, p = 0.040 in non-lung cancer malignancies; 93.8% vs. 73.8%, p = 0.002 in benign processes). The tissue specimens obtained via EBUS-TMC were significantly larger than those via EBUS-IFB (16.3 mm2 vs. 3.1 mm2, p < 0.001). Adding EBUS-IFB did not improve accuracy when EBUS-TMC was already used with EBUS-TBNA. No severe complications leading to death or disability were observed.Conclusions EBUS-TMC is an effective diagnostic and auxiliary method for mediastinal/hilar lesions, enhancing yield rates and tissue acquisition.https://www.tandfonline.com/doi/10.1080/07853890.2025.2550581Diagnostic accuracyendobronchial ultrasound-guided transbronchial intranodal forceps biopsyendobronchial ultrasound-guided transbronchial needle aspirationendobronchial ultrasound-guided transbronchial mediastinal cryobiopsymediastinal/hilar lesionssample size |
| spellingShingle | Ching-Kai Lin Sheng-Yuan Ruan Hung-Jen Fan Hao-Chun Chang Yen-Ting Lin Chao-Chi Ho Comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal and hilar lesions: a prospective observational study Annals of Medicine Diagnostic accuracy endobronchial ultrasound-guided transbronchial intranodal forceps biopsy endobronchial ultrasound-guided transbronchial needle aspiration endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy mediastinal/hilar lesions sample size |
| title | Comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal and hilar lesions: a prospective observational study |
| title_full | Comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal and hilar lesions: a prospective observational study |
| title_fullStr | Comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal and hilar lesions: a prospective observational study |
| title_full_unstemmed | Comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal and hilar lesions: a prospective observational study |
| title_short | Comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal and hilar lesions: a prospective observational study |
| title_sort | comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound guided transbronchial needle aspiration for mediastinal and hilar lesions a prospective observational study |
| topic | Diagnostic accuracy endobronchial ultrasound-guided transbronchial intranodal forceps biopsy endobronchial ultrasound-guided transbronchial needle aspiration endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy mediastinal/hilar lesions sample size |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2550581 |
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