An Australian study presented at the 2019 ERS Congress has shown high levels of agreement between transbronchial lung cryobiopsy and surgical lung biopsy for ILD diagnosis.
Although cryobiopsy has already been adopted in many centres, the findings support its clinical utility as an alternative to surgery in patients requiring lung tissue for their ILD diagnosis.
The COLDICE study, published concurrently in The Lancet Respiratory Medicine, involved 65 patients across nine sites who each had the two procedures performed sequentially under a single general anaesthetic.
Dr Lauren Troy, from the Royal Prince Alfred Hospital and University of Sydney, told the Congress there was a high level of agreement – about 70% – between paired cryobiopsy and surgical lung biopsy specimens when reviewed for histopathological pattern.
De-identified clinical and radiological details from patients were also presented to a panel of experts who each formed their initial individual diagnosis and then reached consensus diagnosis.
The 130 tissue specimens were then added to the diagnostic process and again considered by the panel for final individual and consensus diagnosis.
The level of the agreement between paired samples was nearly 77%.
Just over half of the final diagnoses were idiopathic pulmonary fibrosis and about a quarter were hypersensitivity pneumonitis. The range of other diagnosis included small numbers of sarcoidosis, smoking-related ILD, connective tissue disease-ILD, lymphangioleiomyomatosis, unclassifiable ILD and non-ILD.
Dr Troy said when considering definite and high confidence diagnoses at multidisciplinary discussions (MDD), the agreement between cryobiopsy and surgical lung biopsy was excellent at 95%.