Korevaar, Daniel A., Colella, Sara, Fally, Markus ORCID: 0000-0002-1339-2918, Camuset, Juliette, V. Colby, Thomas, Hagmeyer, Lars, Hetzel, Juergen, Maldonado, Fabien, Morais, Antonio ORCID: 0000-0001-8348-8651, Ravaglia, Claudia, Spijker, Rene ORCID: 0000-0003-4445-1201, Tomassetti, Sara, Troy, Lauren K., Verschakelen, Johny A., Wells, Athol U., Tonia, Thomy, Annema, Jouke T. and Poletti, Venerino (2022). European Respiratory Society guidelines on transbronchial lung cryobiopsy in the diagnosis of interstitial lung diseases. Eur. Resp. J., 60 (5). SHEFFIELD: EUROPEAN RESPIRATORY SOC JOURNALS LTD. ISSN 1399-3003

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Abstract

Background In patients with interstitial lung diseases (ILD), histopathological input is often required to obtain a diagnosis. Surgical lung biopsy (SLB) is considered the reference standard, but many patients are clinically unfit to undergo this invasive procedure, and adverse events, length of hospitalisation and costs are considerable. This European Respiratory Society (ERS) guideline provides evidence-based clinical practice recommendations for the role of transbronchial lung cryobiopsy (TBLC) in obtaining tissue-based diagnosis in patients with undiagnosed ILD.Methods The ERS Task Force consisted of clinical experts in the field of ILD and/or TBLC and methodological experts. Four PICO (Patient, Intervention, Comparator, Outcomes) questions and two narrative questions were formulated. Systematic literature searches were performed in MEDLINE and Embase (up to June 2021). GRADE (Grading, Recommendation, Assessment, Development and Evaluation) methodology was applied.Results In patients with undiagnosed ILD and an indication to obtain histopathological data: 1) TBLC is suggested as a replacement test in patients considered eligible to undergo SLB, 2) TBLC is suggested in patients not considered eligible to undergo SLB, 3) SLB is suggested as an add-on test in patients with a non-informative TBLC, 4) no recommendation is made for or against a second TBLC in patients with a non-informative TBLC and 5) TBLC operators should undergo training, but no recommendation is made for the type of training required.Conclusions TBLC provides important diagnostic information in patients with undiagnosed ILD. Diagnostic yield is lower compared to SLB, at reduced serious adverse events and length of hospitalisation. Certainty of the evidence is mostly very low.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Korevaar, Daniel A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Colella, SaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fally, MarkusUNSPECIFIEDorcid.org/0000-0002-1339-2918UNSPECIFIED
Camuset, JulietteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
V. Colby, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hagmeyer, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hetzel, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maldonado, FabienUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morais, AntonioUNSPECIFIEDorcid.org/0000-0001-8348-8651UNSPECIFIED
Ravaglia, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spijker, ReneUNSPECIFIEDorcid.org/0000-0003-4445-1201UNSPECIFIED
Tomassetti, SaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Troy, Lauren K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Verschakelen, Johny A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wells, Athol U.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tonia, ThomyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Annema, Jouke T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Poletti, VenerinoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-697693
DOI: 10.1183/13993003.00425-2022
Journal or Publication Title: Eur. Resp. J.
Volume: 60
Number: 5
Date: 2022
Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD
Place of Publication: SHEFFIELD
ISSN: 1399-3003
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
IDIOPATHIC PULMONARY-FIBROSIS; MULTIDISCIPLINARY DIAGNOSIS; NEEDLE ASPIRATION; CLINICAL-PRACTICE; BIOPSY; SAFETY; YIELDMultiple languages
Respiratory SystemMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69769

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