The modified biopsy technique conducting ultrasound bronchoscopy with endosonographic-guided position of the endoscopic instrument in the area of the pathological focus. The results of the first phase of the clinical trial

Cover Page

Cite item

Full Text

Abstract

Background. The problem of diagnostics and treatment of malignant neoplasms of the lungs is urgent. Verification of a malignant process in the case of peripheral localization of a neoplasm in the lung using ultrasound bronchoscopy ranges from 30 to 85%. To improve the efficiency of ultrasound bronchoscopy, a modified biopsy technique for ultrasound bronchoscopy was developed and introduced into clinical practice at the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine. The essence of the modified technique is that it becomes possible for ultrasound visual control over the passage and deployment of biopsy forceps in real time. The technique was patented, patent for invention RU №2719666 C1 was issued.

Aim. To clarify the information content of ultrasound bronchoscopy using a modified technique.

Materials and methods. On the basis of the endoscopic Department of Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine in 2019 and 2020, ultrasound bronchoscopy using this technique was performed on 40 patients with suspected peripheral malignant neoplasm of the lungs. The diagnosis of malignant neoplasm was verified in 67.5% of cases. Using the standard biopsy technique, the probability of verification of lung malignant neoplasms in 2019 and 2020 was 57.7%. Thus, the modified biopsy technique made it possible to increase the verification probability by 9.8%. The modified technique is relatively safe, complications during the procedure were detected in 2 patients (in 3.8% of cases) and were successfully treated conservatively. During and after the procedure, the patients were monitored and monitored. The ultrasound bronchoscopy according to the modified technique was satisfactorily tolerated by the patients.

Results. The period of examination of patients when using this technique does not increase. The technique replaces more invasive diagnostic procedures.

Conclusion. The use of the modified technique will improve the information content of ultrasound bronchoscopy, shorten the examination time for patients and accelerate the appointment of special treatment methods.

About the authors

Evgenii A. Pushkarev

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Author for correspondence.
Email: eugenepushkarev@yahoo.com
ORCID iD: 0000-0001-9540-4910

oncologist, endoscopist

Russian Federation, Chelyabinsk

Andrei V. Vazhenin

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine; South Ural State Medical University

Email: vav222@mail.ru

D. Sci. (Med.), Prof., Acad. RAS

Russian Federation, Chelyabinsk

Konstantin I. Kulaev

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Email: konstant01_chel@mail.ru

Cand. Sci. (Med.)

Russian Federation, Chelyabinsk

Ildar M. Iusupov

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Email: credo88@yandex.ru

oncologist, endoscopist

Russian Federation, Chelyabinsk

Konstantin S. Zuikov

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Email: antrax81@rambler.ru

oncologist, endoscopist

Russian Federation, Chelyabinsk

Inna A. Popova

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Email: inna_33@mail.ru

oncologist, endoscopist

Russian Federation, Chelyabinsk

References

  1. Соколов В.В., Соколов Д.В., Пирогов С.С., и др. Современная бронхоскопическая диагностика раннего центрального рака легкого (обзор литературы). Медицинский совет. 2016;15:62-6 [Sokolov VV, Sokolov DV, Pirogov SS, et al. Sovremennaia bronkhoskopicheskaia diagnostika rannego tsentralnogo raka legkogo (obzor literatury). Meditsinskii sovet. 2016;15:62-6 (in Russian)].
  2. Яблонский П.К., Петров А.С., Земцова И.Ю., Атюков М.А. Отдаленные результаты хирургического лечения больных немелкоклеточным раком легкого при pN0-N1. Вопросы онкологии. 2017;63(1):99-103 [Iablonskii PK, Petrov AS, Zemtsova IIu, Atiukov MA. Otdalennye rezultaty khirurgicheskogo lecheniia bolnykh nemelkokletochnym rakom legkogo pri pN0-N1. Voprosy onkologii. 2017;63(1):99-103 (in Russian)].
  3. Злокачественные новообразования в России в 2019 году (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. М.: МНИОИ им. П.А. Герцена, 2020 [Zlokachestvennye novoobrazovaniia v Rossii v 2019 godu (zabolevaemost' i smertnost'). Pod red. AD Kaprina, VV Starinskogo, AO Shakhzadovoi. Moscow: MNIOI im. PA Gertsena, 2020 (in Russian)].
  4. Былин М.В., Черемисина О.В., Панкова О.В., и др. Эффективность комплексной эндоскопической диагностики первичного и первично-множественного рака легкого. Поволжский онкологический вестник. 2017;2(29):8-15 [Bylin MV, Cheremisina OV, Pankova OV, et al. Effektivnost kompleksnoi endoskopicheskoi diagnostiki pervichnogo i pervichno-mnozhestvennogo raka legkogo. Povolzhskii onkologicheskii vestnik. 2017;2(29):8-15 (in Russian)].
  5. Маринов Д.Т., Камаева О.В., Чекалова М.А. Морфологическая верификация периферического рака легкого посредством трансторакальной пункции под контролем УЗИ и КТ. Сибирский онкологический журнал. 2013;2:49-50 [Marinov DT, Kamaeva OV, Chekalova MA. Morfologicheskaia verifikatsiia perifericheskogo raka legkogo posredstvom transtorakalnoi punktsii pod kontrolem UZI i KT. Sibirskii onkologicheskii zhurnal. 2013;2:49-50 (in Russian)].
  6. Рудык Т.Е., Фролова И.Г., Самцов С.А., и др. Роль пистолетной биопсии в комбинированном лечении немелкоклеточного рака легкого. Сибирский онкологический журнал. 2011;Прил. 2:59-60 [Rudyk TE, Frolova IG, Samtsov SA, et al. Rol pistoletnoi biopsii v kombinirovannom lechenii nemelkokletochnogo raka legkogo. Sibirskii onkologicheskii zhurnal. 2011;Suppl. 2:59-60 (in Russian)].
  7. Арсеньев А.И., Барчук А.А., Костицын К.А., и др. Когортное исследование эффективности низкодозной компьютерной томографии и трансторакальной трепан-биопсии в ранней диагностике рака легкого. Вестник хирургии им. И.И. Грекова. 2018;177(1):60-4 [Arsenev AI, Barchuk AA, Kostitsyn KA, et al. Kogortnoe issledovanie effektivnosti nizkodoznoi kompiuternoi tomografii i transtorakalnoi trepan-biopsii v rannei diagnostike raka legkogo. Vestnik khirurgii im. I.I. Grekova. 2018;177(1):60-4 (in Russian)].
  8. Кулаев К.И., Важенин А.В., Утин К.Г., и др. Применение эндоскопических ультразвуковых зондов для морфологической диагностики периферических новообразований легких. Уральский медицинский журнал. 2017;4:42-5 [Kulaev KI, Vazhenin AV, Utin KG, et al. Primenenie endoskopicheskikh ultrazvukovykh zondov dlia morfologicheskoi diagnostiki perifericheskikh novoobrazovanii legkikh. Uralskii meditsinskii zhurnal. 2017;4:42-5 (in Russian)].
  9. Кулаев К.И., Важенин А.В., Зуйков К.С., Юсупов И.М. Модифицированная методика получения материала периферических новообразований легкого при EBUS-GS. Уральский медицинский журнал. 2018;1:136-52 [Kulaev KI, Vazhenin AV, Zuikov KS, Iusupov IM. Modifitsirovannaia metodika polucheniia materiala perifericheskikh novoobrazovanii legkogo pri EBUS-GS. Uralskii meditsinskii zhurnal. 2018;1:136-52 (in Russian)].
  10. Fuso L, Varone F, Magnini D, et al. Role of ultrasound-guided transbronchial biopsy in the diagnosis of peripheral pulmonary lesions. Lung Cancer. 2013;81(1):60-4.
  11. Ikezawa Y, Shinagawa N, Sukoh N, et al. Usefulness of Endobronchial Ultrasonography With a Guide Sheath and Virtual Bronchoscopic Navigation for Ground-Glass Opacity Lesions. Ann Thorac Surg. 2017;103(2):470-5.
  12. Ito T, Taniguchi H, Kondoh Y, et al. Diagnostic Feasibility Of Peripheral Pulmonary Lesions By Endobronchial Ultrasonography With A Guide Sheath Transbronchial Biopsy For Patients With Interstitial Lung Disease. A45. Interventional Pulmonary: clinical studies. American Thoracic Society. Am J Respir Crit Care Med. 2017;195:A1676.
  13. Kurimoto N, Murayama M, Yoshioka S, et al. Assessment of usefulness of endobronchial ultrasonography in determination of depth of tracheobronchial tumor invasion. Chest. 1999;115(6):1500-6.
  14. Kurimoto N, Miyazawa T, Okimasa S, et al. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically. Chest. 2004;126(3):959-65.
  15. Kurimoto N, Inoue T, Miyazawa T, et al. The usefulness of endobronchial ultrasonography–guided transbronchial needle aspiration at the lobar, segmental, or subsegmental bronchus smaller than a convex-type bronchoscope. J Bronchology Interv Pulmonol. 2014;21(1):6-13.
  16. Kurimoto N, Isobe T, Miyazawa T, et al. Endobronchial Ultrasonography for Peripheral Pulmonary Lesions. Ultrasound Med Biol. 2017;43:30-1.
  17. Sarwar G, Arnold D, Tehseen N, Twaddell S. Higher Diagnostic Yield by Adding Conventional Bronchoscopic Sampling to Radial Probe EBUS for Peripheral Pulmonary Lesions. EC Pulmonol Respir Med. 2018;7(10):730-4.

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. The distal hood of bronchoscope Olympus BF type Q180.

Download (50KB)
3. Fig. 2. Bronchoscope Olympus BF type Q180 with the guide tube.

Download (70KB)
4. Fig. 3. Scanning the area where the neoplasm is determined.

Download (69KB)
5. Fig. 4. The conduction of the biopsy forceps in the focus of the neoplasm.

Download (64KB)
6. Fig. 5. The ultrasound appearance of the hyperechoic focus in the projection of the neoplasm.

Download (73KB)
7. Fig. 6. The structure of the diagnostic imaging of malignant neoplasms of the lungs.

Download (110KB)

Copyright (c) 2021 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies