Endobronchial ultrasonography with a guide sheath for pure or mixed ground-glass opacity lesions

Respiration. 2014;88(2):137-43. doi: 10.1159/000362885. Epub 2014 Jul 2.


Background: Ground-glass opacity (GGO) lesions are difficult to diagnose by transbronchial biopsy (TBB).

Objectives: We attempted to diagnose solitary peripheral GGO predominant-type lesions by TBB using endobronchial ultrasonography with a guide sheath (EBUS-GS) under X-ray fluoroscopic guidance, and to evaluate several factors associated with diagnostic yield.

Methods: The medical records of 67 patients with GGO predominant-type lesions who underwent TBB using EBUS-GS under X-ray fluoroscopic guidance were retrospectively reviewed.

Results: Of the 67 lesions, 38 (57%) were successfully diagnosed by EBUS-GS (5/11 pure GGO lesions and 33/56 mixed GGO lesions). The diagnosable lesions were significantly larger than the nondiagnosable lesions (24 vs. 17 mm, respectively; p < 0.01). Regarding the diagnostic yield by signs on computed tomography, the lesions with a bronchus leading directly to a lesion had a significantly higher diagnostic yield than the others (p < 0.05). When GGO lesions were confirmed under X-ray fluoroscopic guidance, the diagnostic yield was 79% (vs. 40% in lesions not visible on X-ray fluoroscopy; p < 0.05).

Conclusions: EBUS-GS is a useful and valuable diagnostic modality, even for GGO predominant-type lesions located at the lung periphery.

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchoscopy*
  • Female
  • Fluoroscopy
  • Humans
  • Lung / pathology
  • Lung Neoplasms / diagnosis*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Ultrasonography, Interventional*
  • Young Adult