Procedural Techniques, Airway Management and Specimen Acquisition for Peripheral Lung Transbronchial and Endobronchial Ultrasound Guided Cryobiopsy: A Modified Delphi Consensus Statement

BACKGROUND: Transbronchial cryobiopsy has expanded beyond its established role in interstitial lung disease, driven by release of single-use cryoprobes, most notably the 1.1-mm cryoprobe. As use of transbronchial cryobiopsy accelerates across non-interstitial lung disease diagnostic contexts, practice variability has outpaced evidence generation and formal guidance. RESEARCH QUESTION: Our objective was to formulate clinical consensus statements regarding indications, tools, techniques, specimen handling, safety considerations, and requisite procedural expertise for the use of the 1.1mm cryoprobe in non-interstitial lung disease transbronchial cryobiopsy, including convex-probe endobronchial ultrasound guided, and peripheral pulmonary lesion, sampling. STUDY DESIGN AND METHODS: An international panel of bronchoscopy experts was assembled through the Interventional Pulmonology Outcomes Group. Following a structured evidence review, a modified Delphi methodology was conducted, consisting of an initial round of open-ended questions followed by three rounds in which panelists rated their agreement with statements on a 5-point Likert scale. Consensus was defined a priori as

• Beattie, J. A.
• Kapp, C. M.
• Thiboutot, J.
• Aboudara, M. C.
• Akulian, J.
• Argento, A. C.
• Casal, R. F.
• Cheng, G.
• De Cardenas, J.
• DeMaio, A.
• Diez-Ferrer, M.
• Fan, Y.
• Gonzales, A. V.
• Herth, F.
• Husta, B.
• Ji, W.
• Kagima, J. W.
• Keyes, C.
• Kim, Y. W.
• Liberman, M.
• Majid, A.
• Navani, N.
• Oberg, C. L.
• Poletti, V.
• Seides, B. J.
• Silvestri, G.
• Wahidi, M.
• Yu, D. H.
• Maldonado, F.
• Feller-Kopman, D.
• Yarmus, L. B.
• Gilbert, C. R.