Evaluating diagnostic yield and accuracy as key performance metrics in pulmonary lung lesions
ObjectiveA conservative definition of diagnostic yields for assessing the performance of guided bronchoscopy has been proposed, but it has yet to be validated in practice.MethodsPatients who underwent radial endobronchial ultrasound (R-EBUS) between April 2020 and April 2023 were included in the stu...
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Frontiers Media S.A.
2025-05-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1572779/full |
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| author | Junsu Choe Hyunseung Nam Hwan-ho Cho Sun Hye Shin Byeong-Ho Jeong Sang-Won Um Hojoong Kim Kyungjong Lee |
| author_facet | Junsu Choe Hyunseung Nam Hwan-ho Cho Sun Hye Shin Byeong-Ho Jeong Sang-Won Um Hojoong Kim Kyungjong Lee |
| author_sort | Junsu Choe |
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| description | ObjectiveA conservative definition of diagnostic yields for assessing the performance of guided bronchoscopy has been proposed, but it has yet to be validated in practice.MethodsPatients who underwent radial endobronchial ultrasound (R-EBUS) between April 2020 and April 2023 were included in the study. Diagnostic results were classified as malignant or non-malignant based on the post-lung-biopsy pathology. Non-malignant results were further categorized into specific benign (SB), nonspecific benign (NSB), atypical cells, and non-diagnostic (ND). All non-malignant lesions were confirmed using alternative biopsy methods or chest computed tomography (CT) during a follow-up of over 1 year. Diagnostic yield and accuracy were calculated using pre-defined methods (Box below). Predictors of sampling success were identified in a logistic regression analysis.ResultsAmong the 736 patients evaluated in this study, R-EBUS-guided TBLB revealed malignancy in 431 (58.6%) patients. The remaining 305 (41.4%) patients with non-malignant lesions were classified as SB (8.3%), NSB (21.3%), atypia (4.6%), and ND (7.2%). Diagnostic yield vs. accuracy values based on conservative, intermediate, and liberal definitions were 67% vs. 67, 88% vs. 77, and 100% vs. 79%, respectively. Thus, for the conservative definition, diagnostic accuracy and diagnostic yield were identical. Significant predictive factors for successful lung biopsy according to the conservative diagnostic yield included lesion size (> 20 mm), CT-bronchus subclassification (Ia, Ib), and radial probe position within the lesion.ConclusionOur study validated the use of the conservative definition of diagnostic yield as a reliable diagnostic endpoint for evaluating the performance of guided bronchoscopy. This definition could serve as a time-saving standard in prospective studies comparing the diagnostic effectiveness of various navigation devices. |
| format | Article |
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| institution | OA Journals |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-9255e5a17e1b4e5ea0fe257ebc5931ef2025-08-20T02:16:02ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15727791572779Evaluating diagnostic yield and accuracy as key performance metrics in pulmonary lung lesionsJunsu Choe0Hyunseung Nam1Hwan-ho Cho2Sun Hye Shin3Byeong-Ho Jeong4Sang-Won Um5Hojoong Kim6Kyungjong Lee7Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Electronics Engineering, Incheon National University, Incheon, Republic of KoreaDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaObjectiveA conservative definition of diagnostic yields for assessing the performance of guided bronchoscopy has been proposed, but it has yet to be validated in practice.MethodsPatients who underwent radial endobronchial ultrasound (R-EBUS) between April 2020 and April 2023 were included in the study. Diagnostic results were classified as malignant or non-malignant based on the post-lung-biopsy pathology. Non-malignant results were further categorized into specific benign (SB), nonspecific benign (NSB), atypical cells, and non-diagnostic (ND). All non-malignant lesions were confirmed using alternative biopsy methods or chest computed tomography (CT) during a follow-up of over 1 year. Diagnostic yield and accuracy were calculated using pre-defined methods (Box below). Predictors of sampling success were identified in a logistic regression analysis.ResultsAmong the 736 patients evaluated in this study, R-EBUS-guided TBLB revealed malignancy in 431 (58.6%) patients. The remaining 305 (41.4%) patients with non-malignant lesions were classified as SB (8.3%), NSB (21.3%), atypia (4.6%), and ND (7.2%). Diagnostic yield vs. accuracy values based on conservative, intermediate, and liberal definitions were 67% vs. 67, 88% vs. 77, and 100% vs. 79%, respectively. Thus, for the conservative definition, diagnostic accuracy and diagnostic yield were identical. Significant predictive factors for successful lung biopsy according to the conservative diagnostic yield included lesion size (> 20 mm), CT-bronchus subclassification (Ia, Ib), and radial probe position within the lesion.ConclusionOur study validated the use of the conservative definition of diagnostic yield as a reliable diagnostic endpoint for evaluating the performance of guided bronchoscopy. This definition could serve as a time-saving standard in prospective studies comparing the diagnostic effectiveness of various navigation devices.https://www.frontiersin.org/articles/10.3389/fmed.2025.1572779/fulldiagnostic yieldsradial endobronchial ultrasoundlung nodulesnavigation bronchoscopytissue diagnosis |
| spellingShingle | Junsu Choe Hyunseung Nam Hwan-ho Cho Sun Hye Shin Byeong-Ho Jeong Sang-Won Um Hojoong Kim Kyungjong Lee Evaluating diagnostic yield and accuracy as key performance metrics in pulmonary lung lesions Frontiers in Medicine diagnostic yields radial endobronchial ultrasound lung nodules navigation bronchoscopy tissue diagnosis |
| title | Evaluating diagnostic yield and accuracy as key performance metrics in pulmonary lung lesions |
| title_full | Evaluating diagnostic yield and accuracy as key performance metrics in pulmonary lung lesions |
| title_fullStr | Evaluating diagnostic yield and accuracy as key performance metrics in pulmonary lung lesions |
| title_full_unstemmed | Evaluating diagnostic yield and accuracy as key performance metrics in pulmonary lung lesions |
| title_short | Evaluating diagnostic yield and accuracy as key performance metrics in pulmonary lung lesions |
| title_sort | evaluating diagnostic yield and accuracy as key performance metrics in pulmonary lung lesions |
| topic | diagnostic yields radial endobronchial ultrasound lung nodules navigation bronchoscopy tissue diagnosis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1572779/full |
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