{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T00:16:25Z","timestamp":1793837785572,"version":"4.6.1"},"reference-count":17,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>The bronchoalveolar lavage (BAL) recovery rate should generally be more than 30% for effective diagnosis. However, there have been no reports investigating a target bronchus for BAL, and the cause of BAL recovery failure is uncertain. Therefore, this study detected predictive factors for BAL recovery failure through investigations on a target bronchus for BAL by using a 3D image analysis system. Therefore, this study detected predictive factors for BAL recovery failure.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Materials and methods<\/jats:title><jats:p>We retrospectively collected data from 338 adult patients who underwent BAL procedures at Fukujuji Hospital from June 2018-March 2022. Factors correlated with the BAL recovery rate were detected. Furthermore, the patients were divided into the failure group (recovery rate &lt;30%; 36 patients) and the success group (recovery rate \u226530%; 302 patients), and data were compared between the two groups by analysing the target bronchus by using a 3D image analysis system.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>The patients in the failure group were older (median 74.5 years old [IQR 68.0\u201379.0] vs. median 70.0 years old [IQR 59.0\u201376.0],<jats:italic>p<\/jats:italic>= 0.016), more likely to be male (n = 27 [75.0%] vs. n = 172 [57.0%],<jats:italic>p<\/jats:italic>= 0.048), more likely to have COPD (n = 7 [19.4%] vs. n = 14 [4.6%],<jats:italic>p<\/jats:italic>= 0.003), and more likely to perform a target site of BAL other than the middle\/lingual lobe (n = 11 [30.5%] vs. n = 35 [11.6%],<jats:italic>p<\/jats:italic>= 0.004) than those in the success group. The area of the bronchial wall was positively related to the recovery rate (r = 0.141,<jats:italic>p<\/jats:italic>= 0.009), and the area of the bronchial wall in the failure group was lower than that in the success group (median 10.5 mm<jats:sup>2<\/jats:sup>[interquartile range (IQR) 8.1\u201314.6] vs. median 14.5 mm<jats:sup>2<\/jats:sup>[11.4\u201319.0],<jats:italic>p<\/jats:italic>&lt;0.001).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>The study shows that a thin bronchial wall, COPD, and a target site of BAL other than the middle\/lingual lobe were identified as the predicted factors for BAL recovery failure. The weakness of the bronchial wall might cause bronchial collapse during the BAL procedure.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0275377","type":"journal-article","created":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T17:42:37Z","timestamp":1664559757000},"page":"e0275377","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Analysis of predicted factors for bronchoalveolar lavage recovery failure: An observational study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2465-0118","authenticated-orcid":true,"given":"Masafumi","family":"Shimoda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kozo","family":"Morimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taro","family":"Abe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reina","family":"Asaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Nakajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Okamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kozo","family":"Yoshimori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9734-4579","authenticated-orcid":true,"given":"Ken","family":"Ohta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"issue":"5","key":"pone.0275377.ref001","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1159\/000102890","article-title":"Bronchoalveolar lavage in interstitial lung diseases: does the recovery rate affect the results?","volume":"74","author":"J Schildge","year":"2007","journal-title":"Respiration"},{"issue":"2","key":"pone.0275377.ref002","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/crj.13462","article-title":"What are the factors affecting the recovery rate of bronchoalveolar lavage fluid?","volume":"16","author":"K Shikano","year":"2022","journal-title":"Clin Respir J"},{"issue":"9","key":"pone.0275377.ref003","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1164\/rccm.201202-0320ST","article-title":"An official American Thoracic Society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease","volume":"185","author":"KC Meyer","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"pone.0275377.ref004","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1183\/09031936.05.00033504","article-title":"Bronchoalveolar lavage in COPD: fluid recovery correlates with the degree of emphysema","volume":"25","author":"JM Lofdahl","year":"2005","journal-title":"Eur Respir J"},{"issue":"1","key":"pone.0275377.ref005","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1038\/s41598-021-81313-5","article-title":"Predictors for bronchoalveolar lavage recovery failure in diffuse parenchymal lung disease","volume":"11","author":"K Koda","year":"2021","journal-title":"Sci Rep"},{"issue":"8","key":"pone.0275377.ref006","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/j.rmed.2013.04.016","article-title":"Impact of emphysema and airway wall thickness on quality of life in smoking-related COPD","volume":"107","author":"HA Gietema","year":"2013","journal-title":"Respir Med"},{"issue":"12","key":"pone.0275377.ref007","doi-asserted-by":"crossref","first-page":"2731","DOI":"10.1007\/s00330-008-1089-4","article-title":"MDCT assessment of airway wall thickness in COPD patients using a new method: correlations with pulmonary function tests","volume":"18","author":"T Achenbach","year":"2008","journal-title":"Eur Radiol"},{"issue":"5","key":"pone.0275377.ref008","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1159\/000367900","article-title":"Virtual bronchoscopic navigation for peripheral pulmonary lesions","volume":"88","author":"F Asano","year":"2014","journal-title":"Respiration"},{"issue":"8","key":"pone.0275377.ref009","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1007\/s11517-016-1582-x","article-title":"3D shape analysis to reduce false positives for lung nodule detection systems","volume":"55","author":"AOC Filho","year":"2017","journal-title":"Med Biol Eng Comput"},{"issue":"2","key":"pone.0275377.ref010","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.ejrad.2015.11.026","article-title":"3D lung motion assessments on inspiratory\/expiratory thin-section CT: Capability for pulmonary functional loss of smoking-related COPD in comparison with lung destruction and air trapping","volume":"85","author":"H Koyama","year":"2016","journal-title":"Eur J Radiol"},{"issue":"3","key":"pone.0275377.ref011","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/bmt.2012.244","article-title":"Investigation of the freely available easy-to-use software \u2019EZR\u2019 for medical statistics","volume":"48","author":"Y. Kanda","year":"2013","journal-title":"Bone Marrow Transplant"},{"issue":"8","key":"pone.0275377.ref012","doi-asserted-by":"crossref","first-page":"e43644","DOI":"10.1371\/journal.pone.0043644","article-title":"Bronchoalveolar lavage results are independent of season, age, gender and collection site","volume":"7","author":"HH Olsen","year":"2012","journal-title":"PLoS One"},{"issue":"3","key":"pone.0275377.ref013","doi-asserted-by":"crossref","first-page":"e34232","DOI":"10.1371\/journal.pone.0034232","article-title":"Cell recovery in bronchoalveolar lavage fluid in smokers is dependent on cumulative smoking history","volume":"7","author":"R Karimi","year":"2012","journal-title":"PLoS One"},{"issue":"17","key":"pone.0275377.ref014","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1056\/NEJMoa1106955","article-title":"Small-airway obstruction and emphysema in chronic obstructive pulmonary disease","volume":"365","author":"JE McDonough","year":"2011","journal-title":"N Engl J Med"},{"issue":"8","key":"pone.0275377.ref015","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1183\/09031936.93.03080937","article-title":"Clinical guidelines and indications for bronchoalveolar lavage (BAL): Report of the European Society of Pneumology Task Group on BAL","volume":"3","author":"H Klech","year":"1990","journal-title":"Eur Respir J"},{"issue":"1","key":"pone.0275377.ref016","doi-asserted-by":"crossref","first-page":"20","DOI":"10.5603\/ARM.a2019.0004","article-title":"Is it possible to predict, whether BAL salvage is going to be diagnostic?","volume":"87","author":"S Skoczynski","year":"2019","journal-title":"Adv Respir Med"},{"issue":"2","key":"pone.0275377.ref017","doi-asserted-by":"crossref","first-page":"101","DOI":"10.5603\/ARM.a2021.0012","article-title":"Risk factors for acute exacerbation following bronchoalveolar lavage in patients with suspected idiopathic pulmonary fibrosis: A retrospective cohort study","volume":"89","author":"M Abe","year":"2021","journal-title":"Adv Respir Med"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0275377","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T11:05:39Z","timestamp":1676977539000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0275377"}},"subtitle":[],"editor":[{"given":"Taeyun","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,9,30]]},"references-count":17,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0275377","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,30]]}}}