{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:48:15Z","timestamp":1791874095777,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008126","name":"Jeju National University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008126","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Although radial probe endobronchial ultrasound (R\u2010EBUS) has been used to investigate peripheral pulmonary lesions (PPLs), its diagnostic performance without fluoroscopy remains unclear. We sought to determine the diagnostic yield of R\u2010EBUS\u2010guided transbronchial biopsy (TBB) without fluoroscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a systematic literature review using Pubmed, Embase, and the Cochrane Central Register. Then, we performed a proportional meta\u2010analysis to determine the diagnostic yield of this modality. Subgroup and meta\u2010regression analyses were used to identify factors affecting the performance of R\u2010EBUS\u2010guided TBB without fluoroscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 31 studies consisting of a total of 6491 patients. Pooled overall diagnostic yield of R\u2010EBUS\u2010guided TBB without fluoroscopy was 0.70 (95% confidence interval [CI], 0.67\u20130.74). There was significant heterogeneity across studies (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a089.45%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In subgroup and meta\u2010regression analyses, air bronchus sign on chest computed tomography scans, larger size PPLs, probe location within lesions, and heterogeneous echogenicity were associated with significantly higher diagnostic yield. Diagnostic yield from the upper lobe was statistically lower than that from the middle and lower lobes. Pooled pneumothorax rate was 0.01 (95% CI, 0.01\u20130.01, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a063.51%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>R\u2010EBUS\u2010guided TBB without fluoroscopy appears to be a relatively useful tool with a low pneumothorax rate for the diagnosis of PPLs. Factors mentioned above may affect the diagnostic yield of this tool. Because of substantial between\u2010study heterogeneity, our results should be interpreted with caution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.14733","type":"journal-article","created":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T18:15:22Z","timestamp":1670523322000},"page":"195-205","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Diagnostic yield of radial probe endobronchial ultrasonography\u2010guided transbronchial biopsy without fluoroscopy in peripheral pulmonary lesions: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2626-7099","authenticated-orcid":false,"given":"Jonghoo","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Jeju National University Hospital, Jeju National University School of Medicine  Jeju South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae\u2010Uk","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214726"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.1_suppl.115S"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.175.1.1750239"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.117.4.1049"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00032001"},{"key":"e_1_2_11_7_1","first-page":"1469","article-title":"Radiation dose to patients and clinicians during 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