Improved diagnostic yield of transbronchial lung biopsy in peripheral pulmonary lesions using a combination of endobronchial ultrasound and rapid on-site evaluation

OBJECTIVES: To evaluate the value of rapid on-site evaluation (ROSE) during radial probe endobronchial ultrasound transbronchial lung biopsy (rpEBUS-TBLB) for peripheral pulmonary lesions (PPLs). METHODS: One hundred and six patients with PPLs who received rpEBUS-TBLB were enrolled in this study. One specimen was immediately examined by ROSE and the other was sent to the central laboratory for cytologic diagnosis. The results of ROSE were compared with those of pathological diagnosis. RESULTS: The diagnostic accuracy, sensitivity, and specificity of ROSE during rpEBUS-TBLB for PPLs were 82.1%, 89.6%, and 77.1%, respectively. The procedure times and number of biopsies were less for procedures when ROSE was positive compared with those when ROSE was negative (procedure time: 20.5 ± 7.9 vs. 28.3 ± 7.6 minutes; number of biopsies: 1.6 ± 0.9 vs. 2.8 ± 0.6 times). No serious procedural complications were observed. CONCLUSIONS: ROSE has value for diagnosing PPLs during rpEBUS. It can reduce procedure time, number of biopsies, and complications. ROSE combined with rpEBUS is an effective and safe method for the diagnosis of PPLs.