Confocal Laser Endomicroscopy Guided Cryobiopsy in the Diagnosis of Interstitial Lung Disease

September 3, 2026 updated by: Gang Hou, China-Japan Friendship Hospital

The Diagnostic Performance and Safety of Confocal Laser Endomicroscopy Guided Transbronchial Lung Cryobiopsy in the Diagnosis of Interstitial Lung Disease: a Randomised Controlled Trial

This prospective, single-center, randomized controlled trial compares pCLE-guided TBLC with conventional TBLC in patients with suspected interstitial lung disease. The study evaluates whether pCLE guidance improves diagnostic performance and procedural safety, with outcomes including final diagnosis and biopsy-related complications.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Patients with suspected ILD undergo multidisciplinary evaluation before enrollment and are included when clinical and HRCT findings are insufficient for a definitive diagnosis and histopathological assessment by TBLC is considered necessary. Participants are randomized 1:1 to pCLE-guided TBLC or conventional TBLC. In both groups, biopsy targets are selected according to HRCT and multidisciplinary assessment, and TBLC is performed following established recommendations. In the pCLE-guided group, pCLE is additionally used within the predefined target area before biopsy to assist selection of suitable sampling sites. Histopathological assessment is performed by blinded pulmonary pathologists, and final diagnoses are established through post-biopsy multidisciplinary discussion integrating clinical, radiological, bronchoscopic, and pathological information.

Study Type

Interventional

Enrollment (Actual)

430

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

      • Beijing, China
        • China-Japan Friendship Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Eligibility Criteria:

  1. adults with suspected interstitial lung disease (ILD).
  2. Clinical and HRCT findings insufficient to establish a definitive diagnosis.
  3. Histopathological evaluation by TBLC considered necessary after multidisciplinary discussion.
  4. Age ≥18 years
  5. Written informed consent provided.

Exclusion Criteria:

  1. Contraindications to bronchoscopy or TBLC.
  2. Severe hypoxemia or uncontrolled bleeding risk.
  3. Severe pulmonary hypertension or unstable cardiopulmonary disease.
  4. Active infection.
  5. Pregnancy.
  6. Inability to provide informed consent.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: pCLE-guided group
Patients assigned to this group undergo transbronchial lung cryobiopsy (TBLC) with probe-based confocal laser endomicroscopy (pCLE) guidance. Before bronchoscopy, the target lobe and bronchial segment are determined according to high-resolution computed tomography findings and multidisciplinary evaluation. During the procedure, pCLE is performed within the predefined target region to assess the distal lung parenchyma and assist in selecting an appropriate biopsy site. The pCLE probe is advanced into the distal lung parenchyma for assessment. After pCLE evaluation, TBLC is performed with the cryoprobe positioned approximately 1-2 cm from the pleura. Areas considered suitable for tissue sampling are preferentially selected while potentially unfavorable regions are avoided when feasible. After pCLE assessment, the probe is withdrawn and TBLC is performed at the selected site according to standard procedures.
Probe-based confocal laser endomicroscopy is used before TBLC to assist biopsy-site selection within the predefined target region.
Experimental: Fluoroscopy-guided TBLC
Patients assigned to this group undergo fluoroscopy-guided transbronchial lung cryobiopsy (TBLC). Before bronchoscopy, the target lobe and bronchial segment are determined according to high-resolution computed tomography findings and multidisciplinary evaluation. TBLC is performed within the predefined target region in accordance with published international expert consensus recommendations. Biopsy specimens are subsequently evaluated by histopathology and multidisciplinary discussion.
TBLC is performed at biopsy sites selected according to conventional clinical and radiological assessment without pCLE guidance.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
MDD diagnostic yield after TBLC
Time Frame: 6 months
MDD diagnostic yield after TBLC, defined as the proportion of participants with a specific final diagnosis established by post-biopsy MDD.
6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Occurrence of operation-related complications
Time Frame: 6 months
Final diagnostic categories, biopsy specimen characteristics, bleeding severity and volume, hemostatic interventions, pneumothorax, and mortality within 7 days after TBLC.
6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 3, 2025

Primary Completion (Actual)

July 20, 2026

Study Completion (Actual)

July 27, 2026

Study Registration Dates

First Submitted

December 16, 2024

First Submitted That Met QC Criteria

December 16, 2024

First Posted (Actual)

December 19, 2024

Study Record Updates

Last Update Posted (Actual)

September 8, 2026

Last Update Submitted That Met QC Criteria

September 3, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 2022YFC2404404-1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.