Our Summary

This research study was conducted to assess the safety and effectiveness of a certain type of lung biopsy procedure, called radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB), in diagnosing lung conditions in patients with idiopathic pulmonary fibrosis (IPF). The study was conducted between October 2017 and December 2019.

Patients were divided into three groups: those with usual interstitial pneumonia (UIP), probable UIP, and those with non-interstitial lung disease (non-ILD). The researchers found that the biopsy procedure was less successful in diagnosing conditions in the UIP group compared to the non-ILD group. However, there was no significant difference in success rates between the UIP and probable UIP groups, or between the probable UIP and non-ILD groups.

The study also found that certain factors affected the success of the procedure. These included the average size of the lung lesions, positive bronchus sign on a CT scan, and the presence of the lesion on an ultrasound. The presence of a UIP pattern on a CT scan was associated with a failed diagnosis. However, in patients with UIP, if the lesion was within the ultrasound image, this contributed to a successful diagnosis.

Overall, the research concluded that the RP-EBUS-TBLB procedure can be performed safely and effectively, even in patients with IPF. There were no significant differences in complication rates among the three patient groups.

FAQs

  1. What is the radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) procedure?
  2. How does the presence of a UIP pattern on a CT scan affect the success of the RP-EBUS-TBLB procedure?
  3. Were there any differences in complication rates among the patients with usual interstitial pneumonia (UIP), probable UIP, and non-interstitial lung disease (non-ILD) who underwent the RP-EBUS-TBLB procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung biopsy is to follow all pre-procedure instructions carefully, such as fasting before the procedure and stopping certain medications as advised. It is also important to inform the healthcare team about any allergies or medical conditions before the biopsy. After the procedure, rest and avoid strenuous activities for a few days to allow for proper healing. If there are any unusual symptoms or complications after the biopsy, it is important to contact the healthcare provider immediately.

Suitable For

Patients who are typically recommended for a lung biopsy include those with:

  1. Suspected lung cancer: A lung biopsy may be recommended for patients with suspicious lung nodules or masses that could be indicative of lung cancer.

  2. Interstitial lung disease: Patients with conditions such as idiopathic pulmonary fibrosis, sarcoidosis, or connective tissue diseases may undergo a lung biopsy to confirm the diagnosis and guide treatment.

  3. Suspected infections: Patients with suspected fungal, bacterial, or other types of infections in the lungs may require a lung biopsy to determine the underlying cause and appropriate treatment.

  4. Unknown lung lesions: Patients with unexplained lung lesions or abnormalities on imaging studies may undergo a biopsy to identify the cause of the abnormality.

  5. Monitoring disease progression: In some cases, a lung biopsy may be recommended to assess the progression of a known lung condition or to evaluate treatment effectiveness.

It is important for healthcare providers to carefully evaluate each patient’s individual case and medical history before recommending a lung biopsy to ensure that the procedure is appropriate and necessary.

Timeline

Before the lung biopsy:

  • Patient consultation with a pulmonologist to discuss the need for a biopsy and potential risks
  • Pre-procedure testing such as blood work, chest X-ray, and possibly a CT scan
  • Patient instructions to fast before the procedure and avoid certain medications
  • Consent form signed by the patient
  • Anesthesia administered before the procedure

During the lung biopsy:

  • Patient positioned on their back or side on the procedure table
  • Local anesthesia applied to numb the area of the biopsy
  • A small incision made in the skin near the lung
  • Biopsy needle inserted through the incision to collect tissue samples
  • Tissue samples sent to a lab for analysis

After the lung biopsy:

  • Patient monitored for any immediate complications such as bleeding or infection
  • Chest X-ray or CT scan to check for any complications or pneumothorax (collapsed lung)
  • Pain medication prescribed for any discomfort
  • Instructions given to the patient on how to care for the biopsy site and when to follow up with the doctor
  • Results of the biopsy discussed with the patient at a follow-up appointment

What to Ask Your Doctor

  1. What is the specific reason for recommending a lung biopsy in my case?

  2. What are the potential risks and complications associated with the RP-EBUS-TBLB procedure?

  3. How will the biopsy results impact my treatment plan and prognosis?

  4. How long will it take to receive the biopsy results?

  5. Are there any alternative diagnostic procedures that could be considered instead of a lung biopsy?

  6. Will I need to make any special preparations before the procedure?

  7. What type of anesthesia will be used during the biopsy, and what are the potential side effects?

  8. How experienced is the medical team in performing RP-EBUS-TBLB procedures?

  9. Will I need to stay in the hospital overnight after the biopsy?

  10. What follow-up care or monitoring will be necessary after the biopsy procedure?

Reference

Authors: Lee J, Kim C, Seol HY, Chung HS, Mok J, Lee G, Jo EJ, Kim MH, Lee K, Kim KU, Park HK, Lee MK, Eom JS. Journal: Respiration. 2022;101(4):401-407. doi: 10.1159/000520034. Epub 2021 Nov 19. PMID: 34802001