Poor Concordance between Sequential Transbronchial Lung Cryobiopsy and Surgical Lung Biopsy in the Diagnosis of Diffuse Interstitial Lung Diseases

Rationale The diagnostic concordancebetween transbronchial lung cryobiopsy (TBLC) -- versus surgical lung biopsy(SLB) as the current gold standard -- in interstitial lung disease(ILD) cases requiring histology remains controversial. Objectives To assess diagnostic concordancebetween TBLC and SLB sequentially performed in the same patients, the diagnostic yield of both techniques, and subsequent changes in multidisciplinary assessment (MDA) decisions. Methods A two-center prospective study included ILD patients with a non-definite usual interstitial pneumonia(UIP) pattern (on HRCT scan) confirmed at a first MDA. Patients underwent TBLC immediately followed by video-assisted thoracoscopyfor SLB at the same anatomical locations. After open-reading of both sample types by local pathologists and final diagnosis at a second MDA (MDA2), anonymized TBLC and SLB slides were blindly assessed by an external expert pathologist (TVC). Kappa- concordancecoefficients and % agreement were computed for: TBLC-vs-SLB;...