The comparative assessment of microbiological examination of radial EBUS specimens vs conventional bronchoscopy in the diagnosis of pulmonary TB

<b>Aim:</b> to assess the microbiological examination in rEBUS vs conventional bronchoscopy (cBr) samples in patients with peripheral pulmonary lesions (PPL) suspecting for TB. <b>Methods:</b> 159 patients with PPL with smear negative tests of sputum for TB were undergoing of bronchoscopy with biopsies under local and general anesthesia. Bronchoscopy with CT navigation (cBs) was performed in 77 pts (40-f, 37-m, age 33±14.4, mean size of PPL-30,83 mm), rEBUS navigation - in 82 pts (40-f, 42-m, age 37±13,2, mean size of PPL-26,87 mm on Chest CT). TBB was performed in 25 pts after rEBUS-navigation, peripheral brushing (BB) - in 103 pts (39-in cBs gr., and 64-in rEBUS gr.), BAL/BW was performed in 152 pts (69+6 - in cBs gr. and 52+25- in rEBUS gr.) for culturing BACTEC MGIT system, microscopy for AFB and real-time PCR for DNA of <i>M. tuberculosis</i>. <b>Results:</b> A diagnosis of TB was confirmed bronchoscopically in 102/159 (64.2%) cases, in 37/77 (48.1%) - in cBs gr. and in 65/82 (79.3%) cases in rEBUS gr. The BB, TBB, and BAL/BW were diagnostic in 25,6% (10/39), 40,0% (2/5) and 43.1% (28/65) cases of cBs gr. and in – 57,8% (37/64), 40.0% (8/20), 59,6% (31/52)/80,0% (20/25) cases of rEBUS gr. respectively. Patients who received the rEBUS navigation had higher diagnostic yields of AFB positive smears (54,9% (45/82) vs 15,6% (12/77), p=.018), positive DNA of <i>M. tuberculosis</i> (69,5% (57/82) vs 42,8% (33/77) and positive culture for TB in BAL/BW/BB specimens (72,0% (59/82) vs. 37,7% (29/77 30/48) p=.024) comparing with cBs gr. <b>Conclusion:</b> The addition of radial EBUS to diagnostic bronchoscopy increased the sensitivity examination on 30% for proving the presence of TB.