Department of Respiratory and Critical Care Medicine, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China, Chengdu, China.
Expert Rev Med Devices. 2024 Sep;21(9):859-867. doi: 10.1080/17434440.2024.2389235. Epub 2024 Aug 6.
The diagnosis of peripheral pulmonary lesions (PPLs) remains challenging. Despite advancements in guided transbronchial biopsy (TBB) techniques, diagnostic yields haven't reached ideal levels. Optical coherence tomography (OCT) has been developed for application in pulmonary diseases, yet no data existed evaluating effectiveness in diagnosing PPLs.
This study included patients who underwent OCT and radial endobronchial ultrasound (R-EBUS)-guided TBB. OCT and R-EBUS imaging features were analyzed to differentiate between benign and malignant PPLs and subtypes of lung cancer.
A total of 89 patients were included in this study. The diagnostic yield of OCT-guided TBB stood at 56.18%, R-EBUS-guided TBB was 83.15% (P<0.01). The accuracy of OCT to judge the nature of lesions was 92.59%, while R-EBUS was 77.92%. The accuracy of OCT in predicting squamous carcinoma (SCC) and adenocarcinoma were both 91.30%.
Although the diagnostic yield of OCT-guided TBB fell short of that achieved by R-EBUS, OCT possessed the capability to judge the nature of lesions and guide the pathological classification of malignant lesions. Further extensive prospective studies are necessary to thoroughly assess the characteristics of this procedure.
https://register.clinicaltrials.gov/ identifier is NCT06419114.
外周肺部病变（PPL）的诊断仍然具有挑战性。尽管经支气管镜引导活检（TBB）技术有所进步，但诊断率仍未达到理想水平。光学相干断层扫描（OCT）已应用于肺部疾病，但尚无数据评估其在诊断 PPL 方面的有效性。
本研究纳入了接受 OCT 和径向支气管内超声（R-EBUS）引导 TBB 的患者。分析了 OCT 和 R-EBUS 成像特征，以区分良性和恶性 PPL 以及肺癌的亚型。
本研究共纳入 89 例患者。OCT 引导 TBB 的诊断率为 56.18%，R-EBUS 引导 TBB 为 83.15%（P<0.01）。OCT 判断病变性质的准确率为 92.59%，而 R-EBUS 为 77.92%。OCT 预测鳞状细胞癌（SCC）和腺癌的准确率均为 91.30%。
尽管 OCT 引导 TBB 的诊断率低于 R-EBUS，但 OCT 具有判断病变性质和指导恶性病变病理分类的能力。需要进一步进行广泛的前瞻性研究，以全面评估该程序的特点。
[ClinicalTrials.gov 标识符](https://register.clinicaltrials.gov/ identifier 是 NCT06419114。
