Bronchoscopic Lung Cryobiopsy Increases Diagnostic Confidence in the Multidisciplinary Diagnosis of XXXX .

@entity1 @entity2416 @entity358 @entity56 @entity401
RATIONALE: Surgical lung biopsy is often required for a confident multidisciplinary diagnosis of @entity2416 ( @entity2416 ). Alternative, less-invasive biopsy methods, such as @entity358 ( @entity358 ), are highly desirable. OBJECTIVES: To address the impact of @entity358 on diagnostic confidence in the multidisciplinary diagnosis of @entity2416 . METHODS: In this cross-sectional study we selected 117 @entity1 with fibrotic @entity401 without a typical @entity2416 pattern on high-resolution computed tomography. All cases underwent lung biopsies: 58 were @entity358 , and 59 were surgical lung biopsy (SLB). Two clinicians, two radiologists, and two pathologists sequentially reviewed clinical-radiologic findings and biopsy results, recording at each step in the process their diagnostic impressions and confidence levels. MEASUREMENTS AND MAIN RESULTS: We observed a major increase in diagnostic confidence after the addition of @entity358 , similar to SLB (from 29 to 63%, P   =   0.0003 and from 30 to 65%, P   =   0.0016 of high confidence @entity2416 diagnosis, in the @entity358 group and SLB group, respectively). The overall interobserver agreement in @entity2416 diagnosis was similar for both approaches ( @entity358 overall kappa, 0.96; SLB overall kappa, 0.93). @entity2416 was the most frequent diagnosis (50 and 39% in the @entity358 and SLB group, respectively; P   =   0.23). After the addition of histopathologic information, 17% of cases in the @entity358 group and 19% of cases in the SLB group, mostly idiopathic nonspecific @entity401 and @entity56 , were reclassified as @entity2416 . CONCLUSIONS: @entity358 is a new biopsy method that has a meaningful impact on diagnostic confidence in the multidisciplinary diagnosis of @entity401 and may prove useful in the diagnosis of @entity2416 . This study provides a robust rationale for future studies investigating the diagnostic accuracy of @entity358 compared with SLB.
