The assessment of Detection Acid Fast Bacilli in specimens of radial EBUS and conventional bronchoscopy and concordance in the diagnosis of pulmonary TB

<b>Aim:</b> To assess the rate of Detection Acid Fast Bacilli (AFB) in specimens of rEBUS and conventional bronchoscopy in comparison with another methods supporting diagnosis of pulmonary TB <b>Methods:</b> 176 patients (84 m and 92 f), aged 13-75 years, were undergoing bronchoscopy with biopsies under local anesthesia. rEBUS were performed in 99 pts, conventional bronchoscopy – (cBs) in 77 pts. All pts of both groups (gr.) had smear negative tests of sputum for TB. After rEBUS navigation or "blindly" TBB was performed in 47 pts (10 in the cBs gr. and 37 - in the rEBUS gr.), brushing - in 140 pts (60-in cBs gr., 80 - in rEBUS gr.) for cytopathology exam. BAL/BW was performed in 170 pts (71- in the of cBs gr., 99 - in rEBUS gr.) for BACTEC MGIT 960 culture, microscopy for AFB (Ziehl-Neelsen staining) and TB PCR. <b>Results:</b> rEBUS found 45 SPN (2.1 cm) and 37 small infiltrates (3.9 cm). Overall diagnosis of pulmonary TB was established in 61.6% (61/99) pts, NTM – 8,1% (8/99), in 15/77 (19.5%) - in cBs gr. Pts who received rEBUS bronchoscopy had higher diagnostic yields of AFB positive detection (51,5% (51/99) vs 11,7% (9/77),p 0.001)) in BAL fluid/BB/BW samples. The concordance of positive AFB with M tuberculosis growth by culture reached 91% (51/56), cytology (granuloma with caseous necrosis) – 100% (51/50) in rEBUS gr, compared to cBr gr in 7 times higher. Total DS yield of all methods for support of DS TB or NTM was 69,7% (69/99): culture – 56,6% (56/99), TB PCR - in 39,4% (38/99) pts, cytopathology exam. – 69,7% in rEBUS gr. <b>Summary:</b> The addition of rEBUS to diagnostic bronchoscopy increased detection of AFB that is important for proving presence of TB