Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: a systematic review and meta-analysis

Ping Zhan; Qing-Qing Zhu; Ying-Ying Miu; Ya-Fang Liu; Xiao-Xia Wang; Ze-Jun Zhou; Jia-Jia Jin; Qian Li; Shinji Sasada; Takehiro Izumo; Chih-Yen Tu; Wen-Chien Cheng; Matthew Evison; Tang-Feng Lv; Yong Song; written on behalf of the AME Lung Cancer Collaborative Group

doi:10.21037/tlcr.2017.01.01

Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: a systematic review and meta-analysis

Transl Lung Cancer Res. 2017 Feb;6(1):23-34. doi: 10.21037/tlcr.2017.01.01.

Authors

Affiliations

¹ Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
² Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Minato-ku, Tokyo 108-0073, Japan.
³ Department of Respiratory Medicine, Japanese Red Cross Medical Center, Shibuya-ku, Tokyo 150-8935, Japan.
⁴ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, China.
⁵ North West Lung Centre, University Hospital of South Manchester, Wythenshawe M23 9LT, UK.

Abstract

Background: With the release of the National Lung Screening Trial results, the detection of peripheral pulmonary lesions (PPLs) is likely to increase. Computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and radial probe endobronchial ultrasound (r-EBUS)-guided transbronchial lung biopsy (TBLB) are recommended for tissue diagnosis of PPLs.

Methods: A systematic review of published literature evaluating the accuracy of r-EBUS-TBLB and CT-PTNB for the diagnosis of PPLs was performed to determine point sensitivity and specificity, and to construct a summary receiver-operating characteristic curve.

Results: This review included 31 publications dealing with EBUS-TBLB and 14 publications dealing with CT-PTNB for the diagnosis of PPLs. EBUS-TBLB had point sensitivity of 0.69 (95% CI: 0.67-0.71) for the diagnosis of peripheral lung cancer (PLC), which was lower than the sensitivity of CT-PTNB (0.94, 95% CI: 0.94-0.95). However, the complication rates observed with EBUS-TBLB were lower than those reported for CT-PTNB.

Conclusions: This meta-analysis showed that EBUS-TBLB is a safe and relatively accurate tool in the investigation of PLC. Although the yield remains lower than that of CT-PTNB, the procedural risks are lower.

Keywords: Computed tomography-guided percutaneous transthoracic needle biopsy (CT-PTNB); diagnosis; meta-analysis; peripheral pulmonary lesions; radial probe endobronchial ultrasound-guided transbronchial lung biopsy (r-EBUS-TBLB).