A Pilot Study on Using SuperDimension when Performing Cryobiopsies

Background: Transbronchial cryobiopsies has become increasingly important in the diagnostic workup for interstitial lung diseases. The rate of complications and mortality are low compared to surgical lung biopsies, but the diagnostic yield is not as high. The reason for the lower diagnostic yield could in some cases be explained by biopsies taken too central or in less affected areas of the lungs. In this pilot study we examined the feasibility of using the electromagnetic navigation system, superDimension (SD), when performing cryobiopsies to increase the diagnostic yield. Methods: Electromagnetic navigation bronchoscopy and cryobiopsies were performed using SD system consisting of an electromagnetic boardplaced on the back of the patient and a position sensor at the tip of the navigational probe which was introduced into the airways through an extended working channel and guided by a real-time 3D reconstruction of previously acquired computer tomography images. Results: In total, 13 patients were included. Disposable 1.7 mm cryoprobes was used in Aarhus (8patients), and reusable 1.9 mm probes in Florence (5 patients). Pneumothorax was detected in three (23%), mild hemorrhage was seen in one (8%) and moderate hemorrhage in six (46%). The biopsies contributed to the diagnosis in 11 of the patients (85%). Conclusion: Using superDimension when performing cryobiopsies is feasible. A larger randomized, controlled, single blinded trial is necessary to homogenize the technique between centres and to evaluate the diagnostic yield and complications.