Cryobiopsy under simultaneous confocal laser endomicroscopy guidance for peripheral pulmonary lesions

<bold>Background:</bold> Radial endobronchial ultrasound (rEBUS) guided transbronchial biopsy (TBB) is the most used technique for diagnosis of peripheral pulmonary lesions (PPL). However, the TBB cannot be performed under simultaneous ultrasound guidance as the EBUS probe has to be removed prior to the biopsy. In order to provide a simultaneous endobronchial imaging-based control during TBB, safety and feasibility of cryobiopsy under simultaneous confocal laser endomicroscopy (CLE) control is examined. <bold>Methods:</bold> In this prospective study, patients with peripheral lesions are enrolled. All patients, in whom the PPL were detected by rEBUS, underwent a CLE-guided cryobiopsy (1.1 mm cryoprobe + AQFlex probe) whereby both probes were advanced simultaneously into the PPL. The primary endpoint of this study is the safety and feasibility. <bold>Results:</bold> So far, 4 patients with PPL underwent CLE-guided cryobiopsy. The cryoprobe and CLE probe could be advanced simultaneously in all lesions. No severe adverse events occurred. In one patient, a mild bleeding after CLE-guided cryobiopsy stopped spontaneously. In one patient, the CLE imaging quality was not sufficient. In 75% (3/4), a definitive diagnosis was made by CLE-guided biopsy. <bold>Conclusion:</bold> Cryobiopsy under simultaneous CLE guidance for PPL seems to be safe and feasible. The study is still ongoing and the final results will be presented at the ERS congress.