Catherine L Oberg1,2, Ryan P Lau3, Erik E Folch4, Tao He5, Reza Ronaghi5, Irawan Susanto5, Colleen Channick5, Rodrigo Garcia Tome5, Scott Oh5. 1. Section of Interventional Pulmonology, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA. coberg@mednet.ucla.edu. 2. Department of Medicine, Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA. coberg@mednet.ucla.edu. 3. Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA. 4. Section of Interventional Pulmonology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02210, USA. 5. Section of Interventional Pulmonology, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.
Abstract
PURPOSE: Tissue acquisition in lung cancer is vital for multiple reasons. Primary reasons reported for molecular testing failure in lung cancer biopsy specimens include insufficient amount of tumor cells provided and inadequate tissue quality. Robotic bronchoscopy is a new tool enabling peripheral pulmonary lesion sampling; however, diagnostic yield remains imperfect possibly due to the location of nodules adjacent to or outside of the airway. The 1.1-mm cryoprobe is a novel diagnostic tool and accesses tissue in a 360-degree manner, thus potentially sampling eccentric/adjacent lesions. This study examines the diagnostic yield of the cryoprobe compared to standard needle aspiration and forceps biopsy. It additionally evaluates yield for molecular markers in cases of lung cancer. METHODS: This is a retrospective analysis of 112 patients with 120 peripheral pulmonary lesions biopsied via robotic bronchoscopy using needle aspirate, forceps, and cryobiopsy. RESULTS: The overall diagnostic yield was 90%. Nearly 18% of diagnoses were made exclusively from the cryobiopsy sample. Molecular analysis was adequate on all cryobiopsy samples sent. Digital imaging software confirmed an increase in quantity and quality of samples taken via cryobiopsy compared to needle aspirate and traditional forceps biopsy. CONCLUSION: Using the 1.1-mm cryoprobe to biopsy PPN combined with the Ion robotic bronchoscopy system is safe, feasible, and provides more diagnostic tissue than needle aspirates or traditional forceps biopsies. The combination of cryobiopsy with robotic-assisted bronchoscopy increased diagnostic yield, likely due to its 360-degree tissue acquisition which is beneficial when targeting extraluminal lesions adjacent to the airway.
PURPOSE: Tissue acquisition in lung cancer is vital for multiple reasons. Primary reasons reported for molecular testing failure in lung cancer biopsy specimens include insufficient amount of tumor cells provided and inadequate tissue quality. Robotic bronchoscopy is a new tool enabling peripheral pulmonary lesion sampling; however, diagnostic yield remains imperfect possibly due to the location of nodules adjacent to or outside of the airway. The 1.1-mm cryoprobe is a novel diagnostic tool and accesses tissue in a 360-degree manner, thus potentially sampling eccentric/adjacent lesions. This study examines the diagnostic yield of the cryoprobe compared to standard needle aspiration and forceps biopsy. It additionally evaluates yield for molecular markers in cases of lung cancer. METHODS: This is a retrospective analysis of 112 patients with 120 peripheral pulmonary lesions biopsied via robotic bronchoscopy using needle aspirate, forceps, and cryobiopsy. RESULTS: The overall diagnostic yield was 90%. Nearly 18% of diagnoses were made exclusively from the cryobiopsy sample. Molecular analysis was adequate on all cryobiopsy samples sent. Digital imaging software confirmed an increase in quantity and quality of samples taken via cryobiopsy compared to needle aspirate and traditional forceps biopsy. CONCLUSION: Using the 1.1-mm cryoprobe to biopsy PPN combined with the Ion robotic bronchoscopy system is safe, feasible, and provides more diagnostic tissue than needle aspirates or traditional forceps biopsies. The combination of cryobiopsy with robotic-assisted bronchoscopy increased diagnostic yield, likely due to its 360-degree tissue acquisition which is beneficial when targeting extraluminal lesions adjacent to the airway.
Authors: Robert J Lentz; A Christine Argento; Thomas V Colby; Otis B Rickman; Fabien Maldonado Journal: J Thorac Dis Date: 2017-07 Impact factor: 2.895
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Authors: Scott Oh; Reza Ronaghi; Tao He; Catherine Oberg; Colleen Channick; Irawan Susanto; Mathew Carroll; S Sam Weigt; David Sayah; Tamas Dolinay; Augustine Chung; Gregory Fishbein; Joseph P Lynch; John A Belperio Journal: Respir Med Date: 2022-06-06 Impact factor: 4.582
Authors: Erik E Folch; Amit K Mahajan; Catherine L Oberg; Fabien Maldonado; Eric Toloza; William S Krimsky; Scott Oh; Mark R Bowling; Sadia Benzaquen; Charles M Kinsey; Atul C Mehta; Sebastian Fernandez-Bussy; Javier Flandes; Kelvin Lau; Ganesh Krishna; Michael A Nead; Felix Herth; Alejandro A Aragaki-Nakahodo; Emanuela Barisione; Sandeep Bansal; Dragos Zanchi; Michael Zgoda; Peter O Lutz; Robert J Lentz; Christopher Parks; Mario Salio; Kenneth Perret; Colleen Keyes; Gregory P LeMense; John D Hinze; Adnan Majid; Merete Christensen; Jordan Kazakov; Gonzalo Labarca; Ernest Waller; Michael Studnicka; Catalina V Teba; Sandeep J Khandhar Journal: Chest Date: 2020-02-14 Impact factor: 9.410
Authors: Michael J Simoff; Michael A Pritchett; Janani S Reisenauer; David E Ost; Adnan Majid; Colleen Keyes; Roberto F Casal; Mihir S Parikh; Javier Diaz-Mendoza; Sebastian Fernandez-Bussy; Erik E Folch Journal: BMC Pulm Med Date: 2021-10-16 Impact factor: 3.317