Comparative effectiveness of radial probe endobronchial ultrasound versus CT-guided needle biopsy for evaluation of peripheral pulmonary lesions: A randomized pragmatic trial

被引:102
作者
Steinfort, Daniel P. [1 ,2 ]
Vincent, Janette [3 ]
Heinze, Stefan [3 ]
Antippa, Phillip [4 ]
Irving, Louis B.
机构
[1] Royal Melbourne Hosp, Dept Resp Med, Med Res Ctr, Parkville, Vic 3050, Australia
[2] Univ Melbourne, Dept Med RMH WH, Parkville, Vic 3010, Australia
[3] Royal Melbourne Hosp, Dept Radiol, Parkville, Vic 3050, Australia
[4] Royal Melbourne Hosp, Dept Cardiothorac Surg, Parkville, Vic 3050, Australia
基金
英国医学研究理事会;
关键词
Bronchoscopy; Diagnostic accuracy; Lung cancer; Non-inferiority; Pneumothorax; FLEXIBLE FIBEROPTIC BRONCHOSCOPY; LUNG-CANCER; CLINICAL-TRIALS; DIAGNOSIS; ASPIRATION; TOMOGRAPHY; EXTENSION; NODULES;
D O I
10.1016/j.rmed.2011.08.008
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
In many patients the optimal method of investigation of peripheral pulmonary lesions (PPL) is not clear. We performed a prospective randomized pragmatic trial to determine the comparative effectiveness of endobronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) and CT-guided percutaneous needle biopsy (CT-PNB) for the investigation of PPL. Overall complication rates were higher in those undergoing CT-PNB (27% v 3%, p = 0.03), while diagnostic accuracy of EBUS-TBLB was shown to be non-inferior to that of CT-PNB. Expected diagnostic accuracy and complication rates are likely to differ for individual patients on the basis of specific complex clinicoradiologic factors, which will influence the cost-benefit analysis between EBUS-TBLB and CT-PNB for individual patients. Further studies are required to examine the effect of these factors on clinical decision-making. Crown Copyright (C) 2011 Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:1704 / 1711
页数:8
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