--- title: "Transbronchial cryobx: dx diffuse parenchymal lung diseases. | Sutter Health" description: "Expert statement proposed during the third international conference on \"Transbronchial Cryobiopsy in Diffuse Parenchymal Lung Disease\" (Ravenna, 10/27-28/2016)." url: "https://www.sutterhealth.org/research/publications/transbronchial-cryobx-dx-diffuse-parenchymal-lung-diseases-1055312384" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Transbronchial cryobx: dx diffuse parenchymal lung diseases. # Transbronchial Cryobiopsies for the Diagnosis of Diffuse Parenchymal Lung Diseases: Expert Statement from the Cryobiopsy Working Group on Safety and Utility and a Call for Standardization of the Procedure. Hetzel J, Maldonado F, Ravaglia C, Wells AU, Colby TV, Tomassetti S, Ryu JH, Fruchter O, Piciucchi S, Dubini A, Cavazza A, Chilosi M, Sverzellati N, Valeyre D, Leduc D, Walsh SLF, Gasparini S, Hetzel M, Hagmeyer L, Haentschel M, Eberhardt R, Darwiche K, Yarmus LB, Torrego A, Krishna G, Shah PL, Annema JT, Herth FJF, & Poletti V. _Respiration. doi: 10.1159/000484055. \[Epub ahead of print\]_ 2018-01-09 ## Abstract Transbronchial cryobiopsies (TBCB) have recently been introduced as a promising and safer alternative to surgical lung biopsy in the diagnostic approach to diffuse parenchymal lung diseases (DPLD). Despite a substantial and expanding body of literature, the technique has not yet been standardized and its place in the diagnostic algorithm of DPLD remains to be defined. In part, this reflects concerns over the diagnostic yield and safety of the procedure, together with the rapid spread of the technique without competency and safety standards; furthermore, there is a substantial procedural variability among centers and interventional pulmonologists. We report this expert statement proposed during the third international conference on "Transbronchial Cryobiopsy in Diffuse Parenchymal Lung Disease" (Ravenna, October 27-28, 2016), which formulates evidence- and expert-based suggestions on the indications, contraindications, patient selection, and procedural aspects of the procedure. The following 5 domains were reviewed: (1) what is the role of TBCB in the diagnostic evaluation of DPLD: patient selection; (2) pathological considerations; (3) contraindications and safety considerations; (4) how should TBCB be performed and in what procedural environment; and (5) who should perform TBCB. Finally, the existence of white paper recommendations may also reassure local hospital credentialing committees tasked with endorsing an adoption of the technique. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/29316560) ![Ganesh Krishna, M.D., FCCP](https://dyn.mktgcdn.com/p/7HZoN6h0d4phO4VQYcU6TE-_Cn72_cBpIS3NRGru51E/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Ganesh Krishna, M.D., FCCP Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/ganesh-krishna-md-fccp-1049681082) ## Research topics - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Lung Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Lung+Diseases%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [A 35-year-old man with fever, dyspnea, and diffuse reticular opacities.](https://www.sutterhealth.org/research/publications/35-yo-man-fever-dyspnea-reticular-oopacities-1055312816) Katikireddy CK, Krishna G, Keifer T, Kuschner W, Rosen G. Chest. 129(2):482-7. 2006 Feb 01 - Publication ### [Update on the treatment of lymphangioleiomyomatosis.](https://www.sutterhealth.org/research/publications/update-treatment-lymphangioleiomyomatosis-1055312862) Krishna G, Berry G, Kao P, Rosen G, Raffin TA. Clin Pulmon Med. 6(2):126-132. 1999 Mar 01 - Publication ### [PG490-88, a derivative of triptolide, blocks bleomycin-induced lung fibrosis.](https://www.sutterhealth.org/research/publications/pg490-88-blocks-bleomycin-induced-lung-fibrosis-1055312795) Krishna G, Liu K, Shigemitsu H, Gao M, Raffin TA, Rosen GD. Am J Pathol. 158(3):997-1004. 2001 Mar 01 - Publication ### [Parasitic pulmonary eosinophilia.](https://www.sutterhealth.org/research/publications/parasitic-pulmonary-eosinophilia-1055312949) Chitkara RK, Krishna G. Semin Respir Crit Care Med. 27(2):171-84. 2006 Apr 01 - Publication ### [Advances in the management of chronic obstructive pulmonary disease.](https://www.sutterhealth.org/research/publications/advances-mgmt-copd-1055312934) Meinke L, Chitkara R, Krishna G. Expert Opin Pharmacother. 8(1):23-37. 2007 Jan 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/transbronchial-cryobx-dx-diffuse-parenchymal-lung-diseases-1055312384#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Transbronchial cryobx: dx diffuse parenchymal lung diseases."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/transbronchial-cryobx-dx-diffuse-parenchymal-lung-diseases-1055312384#medicalscholarlyarticle","name":"Transbronchial Cryobiopsies for the Diagnosis of Diffuse Parenchymal Lung Diseases: Expert Statement from the Cryobiopsy Working Group on Safety and Utility and a Call for Standardization of the Procedure.","headline":"Transbronchial cryobx: dx diffuse parenchymal lung diseases.","abstract":"Transbronchial cryobiopsies (TBCB) have recently been introduced as a promising and safer alternative to surgical lung biopsy in the diagnostic approach to diffuse parenchymal lung diseases (DPLD). Despite a substantial and expanding body of literature, the technique has not yet been standardized and its place in the diagnostic algorithm of DPLD remains to be defined. In part, this reflects concerns over the diagnostic yield and safety of the procedure, together with the rapid spread of the technique without competency and safety standards; furthermore, there is a substantial procedural variability among centers and interventional pulmonologists. We report this expert statement proposed during the third international conference on \"Transbronchial Cryobiopsy in Diffuse Parenchymal Lung Disease\" (Ravenna, October 27-28, 2016), which formulates evidence- and expert-based suggestions on the indications, contraindications, patient selection, and procedural aspects of the procedure. The following 5 domains were reviewed: (1) what is the role of TBCB in the diagnostic evaluation of DPLD: patient selection; (2) pathological considerations; (3) contraindications and safety considerations; (4) how should TBCB be performed and in what procedural environment; and (5) who should perform TBCB. 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