The following is a summary of “Guided Bronchoscopy for the Evaluation of Pulmonary Lesions: An Updated Meta-analysis,” published in the June 2023 issue of the Chest by Nadig et al.

The use of guided bronchoscopy to diagnose peripheral pulmonary lesions (PPLs) is rising. In 2012, a meta-analysis revealed a diagnostic yield of 70%; however, more recent studies have documented outcomes as low as 40% and as high as 90%. Over the past decade, has the diagnostic yield of guided bronchoscopy in patients with PPLs increased? A thorough search was conducted for studies comparing the diagnostic yield of various bronchoscopic techniques used to reach PPLs. The Quality assessment of diagnostic accuracy of studies (QUADAS-2) assessment instrument was used to evaluate the study’s quality. 

The number of lesions, the technology employed, the diagnostic yield overall, and the diagnostic yield by size were extracted. Adverse events were recorded. To summarize findings from all investigations, meta-analytic techniques were used. Included were a total of 16,389 lesions from 126 studies. Before 2012 (39 studies; 3,052 lesions; yield 70.5%), there was no significant difference in diagnostic yield compared to after 2012 (87 studies; 13,535 lesions; pay 69.2%) (P >.05). Furthermore, there was no significant difference in yield between the various technologies. 

Studies with a low overall risk of bias had a lower diagnostic result than those with a high risk of bias (P =.018; 66% vs. 71%, respectively). Significantly higher diagnostic yield was associated with lesions larger than 2 centimeters, bronchus signs, and a high prevalence of malignancy in the study population. Significant (P <.0001) heterogeneity between studies was also observed. Despite advances in bronchoscopic technology for diagnosing PPLs, the diagnostic yield of guided bronchoscopy has remained the same.

Source: sciencedirect.com/science/article/abs/pii/S0012369223000302