Bronchoscopy with and without needle-based confocal laser endomicroscopy for peripheral lung nodule diagnosis: protocol for a multicentre randomised controlled trial (CLEVER trial)
Language English Country England, Great Britain Media electronic
Document type Clinical Trial Protocol, Journal Article, Research Support, Non-U.S. Gov't
PubMed
38964802
PubMed Central
PMC11227804
DOI
10.1136/bmjopen-2023-081148
PII: bmjopen-2023-081148
Knihovny.cz E-resources
- Keywords
- Biopsy, Clinical Trial, Cytopathology, Diagnostic Imaging, Respiratory tract tumours,
- MeSH
- Bronchoscopy * methods MeSH
- Needles MeSH
- Microscopy, Confocal * methods MeSH
- Humans MeSH
- Multicenter Studies as Topic MeSH
- Lung Neoplasms * pathology diagnosis diagnostic imaging MeSH
- Lung pathology diagnostic imaging MeSH
- Randomized Controlled Trials as Topic MeSH
- Solitary Pulmonary Nodule * pathology diagnostic imaging diagnosis MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Clinical Trial Protocol MeSH
INTRODUCTION: Despite many technological advances, the diagnostic yield of bronchoscopic peripheral lung nodule analysis remains limited due to frequent mispositioning. Needle-based confocal laser endomicroscopy (nCLE) enables real-time microscopic feedback on needle positioning, potentially improving the sampling location and diagnostic yield. Previous studies have defined and validated nCLE criteria for malignancy, airway and lung parenchyma. Larger studies demonstrating the effect of nCLE on diagnostic yield are lacking. We aim to investigate if nCLE-imaging integrated with conventional bronchoscopy results in a higher diagnostic yield compared with conventional bronchoscopy without nCLE. METHODS AND ANALYSIS: This is a parallel-group randomised controlled trial. Recruitment is performed at pulmonology outpatient clinics in universities and general hospitals in six different European countries and one hospital in the USA. Consecutive patients with a for malignancy suspected peripheral lung nodule (10-30 mm) with an indication for diagnostic bronchoscopy will be screened, and 208 patients will be included. Web-based randomisation (1:1) between the two procedures will be performed. The primary outcome is diagnostic yield. Secondary outcomes include diagnostic sensitivity for malignancy, needle repositionings, procedure and fluoroscopy duration, and complications. Pathologists will be blinded to procedure type; patients and endoscopists will not. ETHICS AND DISSEMINATION: Primary approval by the Ethics Committee of the Amsterdam University Medical Center. Dissemination involves publication in a peer-reviewed journal. SUPPORT: Financial and material support from Mauna Kea Technologies. TRIAL REGISTRATION NUMBER: NCT06079970.
Department of Pneumology University Hospital Basel Basel Switzerland
Department of Pulmonary Medicine Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
Department of Pulmonary Medicine Montefiore Medical Center Einstein Campus New York New York USA
Imaging and Biomarkers Cancer Center Amsterdam Amsterdam The Netherlands
Pulmonary Unit Department of Thoracic Diseases GB Morgagni Pierantoni Hospital Forli Italy
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NCT06079970
