{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:45:50Z","timestamp":1782283550142,"version":"3.54.5"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>A conservative definition of diagnostic yields for assessing the performance of guided bronchoscopy has been proposed, but it has yet to be validated in practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent radial endobronchial ultrasound (R-EBUS) between April 2020 and April 2023 were included in the study. Diagnostic results were classified as malignant or non-malignant based on the post-lung-biopsy pathology. Non-malignant results were further categorized into specific benign (SB), nonspecific benign (NSB), atypical cells, and non-diagnostic (ND). All non-malignant lesions were confirmed using alternative biopsy methods or chest computed tomography (CT) during a follow-up of over 1\u202fyear. Diagnostic yield and accuracy were calculated using pre-defined methods (Box below). Predictors of sampling success were identified in a logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 736 patients evaluated in this study, R-EBUS-guided TBLB revealed malignancy in 431 (58.6%) patients. The remaining 305 (41.4%) patients with non-malignant lesions were classified as SB (8.3%), NSB (21.3%), atypia (4.6%), and ND (7.2%). Diagnostic yield vs. accuracy values based on conservative, intermediate, and liberal definitions were 67% vs. 67, 88% vs. 77, and 100% vs. 79%, respectively. Thus, for the conservative definition, diagnostic accuracy and diagnostic yield were identical. Significant predictive factors for successful lung biopsy according to the conservative diagnostic yield included lesion size (&amp;gt; 20\u202fmm), CT-bronchus subclassification (Ia, Ib), and radial probe position within the lesion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study validated the use of the conservative definition of diagnostic yield as a reliable diagnostic endpoint for evaluating the performance of guided bronchoscopy. This definition could serve as a time-saving standard in prospective studies comparing the diagnostic effectiveness of various navigation devices.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1572779","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T05:14:33Z","timestamp":1746594873000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating diagnostic yield and accuracy as key performance metrics in pulmonary lung lesions"],"prefix":"10.3389","volume":"12","author":[{"given":"Junsu","family":"Choe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunseung","family":"Nam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwan-ho","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Hye","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byeong-Ho","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Won","family":"Um","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hojoong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungjong","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"8279","DOI":"10.1007\/s00330-023-09826-3","article-title":"Trends in the incidence of pulmonary nodules in chest computed tomography: 10-year results from two Dutch hospitals","volume":"33","author":"Hendrix","year":"2023","journal-title":"Eur Radiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1164\/rccm.201505-0990OC","article-title":"Recent trends in the identification of incidental pulmonary nodules","volume":"192","author":"Gould","year":"2015","journal-title":"Am J Respir Crit Care Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1001\/jama.2021.24287","article-title":"Evaluating the patient with a pulmonary nodule: a review","volume":"327","author":"Mazzone","year":"2022","journal-title":"JAMA"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1183\/09031936.00075310","article-title":"Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis","volume":"37","author":"Steinfort","year":"2011","journal-title":"Eur Respir J"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1111\/resp.12980","article-title":"Radial endobronchial ultrasound for the diagnosis of peripheral pulmonary lesions: a systematic review and meta-analysis","volume":"22","author":"Ali","year":"2017","journal-title":"Respirology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"5422","DOI":"10.21037\/jtd-24-456","article-title":"Robotic-assisted bronchoscopy: a narrative review of systems","volume":"16","author":"Fernandez-Bussy","year":"2024","journal-title":"J Thorac Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"240046","DOI":"10.1183\/16000617.0046-2024","article-title":"Diagnostic yield and safety of diagnostic techniques for pulmonary lesions: systematic review, meta-analysis and network meta-analysis","volume":"33","author":"Balasubramanian","year":"2024","journal-title":"Eur Respir Rev"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1016\/j.chest.2024.02.030","article-title":"Urgently needed!: uniform outcome definitions and improved reporting in advanced diagnostic bronchoscopy studies","volume":"165","author":"Gonzalez","year":"2024","journal-title":"Chest"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1164\/rccm.202401-0192ST","article-title":"Assessment of advanced diagnostic bronchoscopy outcomes for peripheral lung lesions: a Delphi consensus definition of diagnostic yield and recommendations for patient-centered study designs. 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