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• W3092717338 abstract "SESSION TITLE: Procedures Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Radial probe endobronchial ultrasound (R-EBUS) provides real-time confirmation of lesion localization with bronchoscopy for peripheral pulmonary lesions. “Concentric” images indicate a lesion surrounding a bronchus and “eccentric” images indicate lesion position adjacent to the bronchus. While studies have demonstrated higher diagnostic yield with concentric views, there is no clear classification system for distinguishing the two nor for the range of different views that may be observed. This study was performed to assess inter-observer variability in R-EBUS image interpretation and to assess the influence of a grading system on interpretation variability as well as ability to predict procedural outcomes. METHODS: This was a retrospective study of peripheral bronchoscopy cases utilizing radial EBUS performed between 1/2018 and 10/2019. Of 200 cases performed in this study period, the most recent 100 cases with diagnoses and R-EBUS images were included in data analysis. A survey consisting of 100 radial EBUS images was sent to 10 participants (MA, DA, AB, PC, KH, AL, EM, SP, AS, AC) who were asked to classify each image as either “concentric” or “eccentric”. Inter-observer variability was calculated. Additionally, a grading system for R-EBUS images was developed using the following criteria: 1. “Concentric A” indicated that the R-EBUS probe was in contact with the center of the lesion defined as the intersection of lines drawn though the long and short axis of the lesion. 2. “Concentric B” was defined as probe position within the lesion but outside of the center and not interrupting the border of the lesion. 3. “Eccentric” was defined as probe position which interrupted the border of the targeted lesion. Diagnostic yield was calculated for each of these 3 R-EBUS views. RESULTS: “Concentric A” images were identified in 31 cases, “Concentric B” in 23, and “Eccentric” in 46 cases; diagnostic yields for each category were 61% (19/31), 65% (15/23) and 46% (21/46) respectively. The overall kappa reliability coefficient between observers was 0.50 (95% CI 0.42-0.57). CONCLUSIONS: Based on early analysis using a systematic grading system for R-EBUS images, it appears that eccentric lesions defined as those in which the R-EBUS probe interrupts the outline of the targeted lesion showed a trend towards statistical significance for difference in diagnostic yield. While our initial survey shows moderate inter-observer reliability we believe that further evaluation with the revised classification system would improve this. CLINICAL IMPLICATIONS: R-EBUS images may predict the likelihood of obtaining diagnostic biopsies, though image interpretation of concentric and eccentric ultrasound views may be subjective and predisposed to inter-observer variability. A structured classification for grading R-EBUS views may help standardize R-EBUS image interpretation for both clinical use and research purposes. DISCLOSURES: No relevant relationships by Mohammed Abbasi, source=Web Response No relevant relationships by Danish Ahmad, source=Web Response No relevant relationships by Allen Cole Burks, source=Web Response No relevant relationships by Alexander Chen, source=Web Response, value=Grant/Research Support Removed 06/01/2020 by Alexander Chen, source=Web Response No relevant relationships by Alexander Chen, source=Web Response, value=Grant/Research Support Removed 06/01/2020 by Alexander Chen, source=Web Response No relevant relationships by Alexander Chen, source=Web Response, value=Grant/Research Support Removed 06/01/2020 by Alexander Chen, source=Web Response No relevant relationships by Praveen Chenna, source=Web Response no disclosure on file for Kevin Haas; No relevant relationships by Andrea Loiselle, source=Web Response no disclosure on file for Essam Mekhaiel; No relevant relationships by Nathaniel Moulton, source=Web Response No relevant relationships by Tej Patel, source=Web Response no disclosure on file for Suchitra Pilli; Consultant relationship with Olympus America Please note: $5001 - $20000 Added 06/01/2020 by Ali Sadoughi, source=Web Response, value=Consulting fee Consultant relationship with Alpha-Tau Ltd. Please note: $20001 - $100000 Added 06/01/2020 by Ali Sadoughi, source=Web Response, value=Consulting fee" @default.
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• W3092717338 date "2020-10-01" @default.
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• W3092717338 title "REFINING RADIAL EBUS: CHARACTERIZING IMAGING INTERPRETATION AND PROPOSAL FOR A STANDARDIZED GRADING SYSTEM" @default.
• W3092717338 doi "https://doi.org/10.1016/j.chest.2020.08.1676" @default.
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