Comparative effectiveness of radial probe endobronchial ultrasound versus CT-guided needle biopsy for evaluation of peripheral pulmonary lesions: a randomized pragmatic trial

Respir Med. 2011 Nov;105(11):1704-11. doi: 10.1016/j.rmed.2011.08.008. Epub 2011 Aug 27.


In many patients the optimal method of investigation of peripheral pulmonary lesions (PPL) is not clear. We performed a prospective randomized pragmatic trial to determine the comparative effectiveness of endobronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) and CT-guided percutaneous needle biopsy (CT-PNB) for the investigation of PPL. Overall complication rates were higher in those undergoing CT-PNB (27% v 3%, p = 0.03), while diagnostic accuracy of EBUS-TBLB was shown to be non-inferior to that of CT-PNB. Expected diagnostic accuracy and complication rates are likely to differ for individual patients on the basis of specific complex clinicoradiologic factors, which will influence the cost-benefit analysis between EBUS-TBLB and CT-PNB for individual patients. Further studies are required to examine the effect of these factors on clinical decision-making.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Bronchiolo-Alveolar / diagnostic imaging
  • Adenocarcinoma, Bronchiolo-Alveolar / pathology*
  • Aged
  • Biopsy, Needle* / instrumentation
  • Biopsy, Needle* / methods
  • Bronchoscopy* / instrumentation
  • Decision Making
  • Endosonography / instrumentation*
  • Female
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology*
  • Male
  • Neoplasms, Squamous Cell / diagnostic imaging
  • Neoplasms, Squamous Cell / pathology*
  • Prospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*