Radial EBUS – Cryobiopsy

Lin Ching-Kai
National Taiwan University Cancer Centre, Taiwan, Republic of China

Cryobiopsy utilizes compressed gas to induce a Joule-Thomson cooling effect, which freezes surrounding tissue and enables the extraction of larger specimens while preserving their histologic architecture. Transbronchial cryobiopsy (TBC) has become a widely adopted technique for diagnosing endobronchial tumors and interstitial lung diseases, and more recently, it has shown promise in the evaluation of peripheral pulmonary lesions (PPLs). TBC provides ample tissue for both histologic subtyping and molecular analysis, which are critical for guiding targeted cancer therapy.

However, conventional cryoprobes (≥1.7 mm) are often rigid and challenging to maneuver into peripheral bronchi, limiting their utility in certain clinical scenarios. In contrast, the newer 1.1 mm thin cryoprobe offers greater flexibility, facilitating access to small or anatomically difficult-to-reach lesions. Importantly, tissue yield and diagnostic adequacy with the thin cryoprobe are comparable to those achieved with larger probes.
We propose that the integration of thin cryoprobe-based TBC represents a promising strategy for improving diagnostic accuracy in PPLs, particularly in the context of precision oncology.