Our Summary

The COLDICE Study is investigating a new, less invasive way of obtaining lung tissue samples for the diagnosis of interstitial lung disease (ILD), a group of conditions that cause scarring to the lungs. The new technique, called transbronchial lung cryobiopsy (TBLC), is being compared to the current standard method of surgical lung biopsy. The study will involve patients with ILD who need a lung biopsy for their diagnosis. These patients will have both types of biopsies done at the same time, and the samples will be examined by expert pathologists who do not know which method was used to obtain them. The aim is to see if the diagnoses made using the TBLC samples match those made using the surgical samples. The researchers will also look at how much the pathologists agree with each other’s findings, and how much the clinicians agree with each other’s diagnoses. The study is being carried out according to international and Australian ethical guidelines for medical research.

FAQs

  1. What is the purpose of the COLDICE Study?
  2. How does the new transbronchial lung cryobiopsy (TBLC) technique compare to the current standard method of surgical lung biopsy?
  3. Are the diagnoses made using the TBLC samples expected to match those made with surgical samples?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung biopsy is to follow all pre-operative instructions provided by the medical team, such as fasting before the procedure and stopping certain medications. It is also important to discuss any concerns or questions with the medical team before the biopsy to ensure that the patient is well-informed and prepared for the procedure. Additionally, after the biopsy, it is important for the patient to follow all post-operative instructions, such as taking prescribed medications and monitoring for any signs of infection or complications. It is also important to follow up with the medical team for the results of the biopsy and any further treatment recommendations.

Suitable For

Patients who are typically recommended for lung biopsy include those with suspected or confirmed interstitial lung disease, suspected lung cancer, suspected infections such as tuberculosis or fungal infections, suspected autoimmune diseases affecting the lungs, unexplained lung nodules or masses, and unexplained or worsening respiratory symptoms. In the case of the COLDICE Study, patients with ILD who need a lung biopsy for their diagnosis are being included in the research.

Timeline

Before the lung biopsy:

  1. Patient is referred to a pulmonologist for evaluation of their ILD symptoms.
  2. Pulmonologist performs various tests, such as pulmonary function tests and imaging studies, to assess the severity and type of ILD.
  3. Based on the results of these tests, the pulmonologist determines that a lung biopsy is necessary for a definitive diagnosis.
  4. Patient is informed about the risks and benefits of the two biopsy methods (TBLC and surgical biopsy) and gives their consent to participate in the study.
  5. Patient undergoes pre-procedure evaluations, such as blood tests and chest x-rays, to ensure they are suitable candidates for the biopsy.

After the lung biopsy:

  1. Patient is monitored closely in the recovery area for any immediate complications, such as bleeding or pneumothorax.
  2. Patient is discharged home with instructions on post-procedure care and follow-up appointments.
  3. Pathologists examine the tissue samples obtained from both biopsy methods to make a diagnosis.
  4. The pulmonologist discusses the biopsy results with the patient and develops a treatment plan based on the diagnosis.
  5. Patient undergoes follow-up appointments to monitor their response to treatment and disease progression.

What to Ask Your Doctor

  1. What is the purpose of the lung biopsy in my case?
  2. What are the potential risks and complications associated with the lung biopsy procedure?
  3. How is the transbronchial lung cryobiopsy (TBLC) different from the surgical lung biopsy?
  4. What are the benefits of using TBLC compared to the standard surgical biopsy?
  5. How long will it take to recover from the biopsy procedure?
  6. How soon will I receive the results of the biopsy?
  7. What will the biopsy results tell us about my condition and treatment options?
  8. Will I need any additional tests or procedures after the biopsy?
  9. How experienced is the medical team in performing TBLC and analyzing the biopsy samples?
  10. Are there any specific instructions or precautions I should follow before and after the biopsy procedure?

Reference

Authors: Troy LK, Grainge C, Corte T, Williamson JP, Vallely MP, Cooper W, Mahar AM, Lai S, Mulyadi E, Torzillo PJ, Salamonsen M, Don G, Myers J, Raghu G, Lau EMT; COLDICE Investigator Team. Journal: BMJ Open Respir Res. 2019 Jun 21;6(1):e000443. doi: 10.1136/bmjresp-2019-000443. eCollection 2019. PMID: 31321059