Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
doi:10.1378/chest.06-0786
(Chest. 2007; 131:549-553)
© 2007 American College of Chest Physicians
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Shinagawa, N.
Right arrow Articles by Nishimura, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Shinagawa, N.
Right arrow Articles by Nishimura, M.

Factors Related to Diagnostic Sensitivity Using an Ultrathin Bronchoscope Under CT Guidance*

Naofumi Shinagawa, MD, PhD; Koichi Yamazaki, MD, PhD; Yuya Onodera, MD, PhD; Hajime Asahina, MD; Eiki Kikuchi, MD; Fumihiro Asano, MD, PhD; Kazuo Miyasaka, MD, PhD and Masaharu Nishimura, MD, PhD

* From First Department of Medicine (Drs. Shinagawa, Yamazaki, Asahina, Kikuchi, and Nishimura) and Department of Radiology (Drs. Onodera and Miyasaka), Hokkaido University School of Medicine, Sapporo; and Department of Pulmonary Medicine and Interventional Bronchoscopy (Dr. Asano), Gifu Prefectural General Medical Center, Gifu, Japan.

Correspondence to: Koichi Yamazaki, MD, PhD, First Department of Medicine, Hokkaido University School of Medicine, North 15, West 7, Kitaku, Sapporo 060-8638, Japan; e-mail: kyamazak{at}med.hokudai.ac.jp

Abstract

Background: We investigated factors related to the diagnostic sensitivity of CT-guided transbronchial biopsy (TBB) using an ultrathin bronchoscope and virtual bronchoscopy (VB) navigation for small peripheral pulmonary lesions.

Method: We have performed this procedure on 83 patients with 85 small peripheral pulmonary lesions (< 20 mm in diameter). We analyzed the relationship between the diagnostic sensitivity and the location of the lesions, the bronchial generation to which an ultrathin bronchoscope was inserted, and the lesion-bronchial and lesion-pulmonary arterial relationships on high-resolution CT.

Results: Fifty-six of the 85 lesions (66%) were diagnosed following CT-guided TBB using an ultrathin bronchoscope with VB navigation. The lesions located in the left superior segment of the lower lobe (S6) had a significantly low diagnostic sensitivity compared to other locations (p < 0.01). When an ultrathin bronchoscope could be inserted to the fifth or greater bronchial generation, the yield was above the average diagnostic sensitivity of 66%. Moreover, not only the patients with the presence of a bronchus leading directly to a lesion (CT-bronchus sign), but also the patients with the presence of a pulmonary artery leading to a lesion (CT-artery sign), had high diagnostic sensitivity (p < 0.01). Multivariate analysis revealed that the location of lesion was an independent predictor of diagnostic sensitivity (p < 0.05).

Conclusions: The location of the lesion, the bronchial generation to which an ultrathin bronchoscope was inserted, and the presence of a bronchus as well as a pulmonary artery leading to the lesion were valuable for predicting successful CT-guided TBB using an ultrathin bronchoscope with VB navigation.

Key Words: CT artery sign • CT-guided transbronchial biopsy • small peripheral pulmonary lesion • ultrathin bronchoscope • virtual bronchoscopic navigation






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American College of Chest Physicians.