Photo Credit: Henadzi Pechan

The following is a summary of “Comparison of cryo-biopsy and forceps biopsy for the diagnosis of mediastinal lesions: A randomized clinical trial,” published in the January 2024 issue of Pulmonology by Cheng et al.

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the gold standard for lung cancer staging, but small tissue samples may limit its utility for other mediastinal diseases. Novel techniques such as forceps biopsy and cryo-biopsy offer larger tissue yields and potential diagnostic benefits.

This study evaluated the diagnostic efficacy of forceps biopsy and cryo-biopsy as adjuncts to EBUS-TBNA for mediastinal disease diagnosis. Consecutive patients with mediastinal lesions ≥1 cm in short axis were enrolled. Following EBUS-TBNA, three forceps biopsies and one cryo-biopsy were randomly performed. Primary endpoints included diagnostic yield and procedure-related complications.

Among 155 patients, supplementing EBUS-TBNA with either forceps biopsy or cryobiopsy increased diagnostic yield significantly, with comparable rates between forceps biopsy and cryobiopsy (85.7% vs. 91.6%, P = 0.106). However, cryo-biopsies provided superior lung cancer molecular testing samples compared to forceps biopsies (100.0% vs. 89.5%, P = 0.036). The direct comparison showed cryo-biopsy outperformed forceps biopsy in overall diagnostic yield (85.7% vs. 70.8%, P = 0.001), yielding larger samples in less procedural time. Only two cases (1.3%) of postprocedural pneumothorax were reported.

Transbronchial mediastinal cryobiopsy presents a promising adjunctive approach to traditional needle biopsy, offering increased diagnostic yield and superior tissue acquisition.

Source: sciencedirect.com/science/article/pii/S2531043723002404