HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text (PDF) Free All Versions of this Article: chest.06-3016v1 131/6/1800    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Eberhardt, R. Articles by Ernst, A. Search for Related Content PubMed PubMed Citation Articles by Eberhardt, R. Articles by Ernst, A.

Electromagnetic Navigation Diagnostic Bronchoscopy in Peripheral Lung Lesions

¹Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Germany ²Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA

aernst{at}bidmc.harvard.edu

Abstract

BackgroundElectromagnetic Navigation Bronchoscopy (ENB) with biopsy under fluoroscopic guidance has enhanced the yield of flexible bronchoscopy in the diagnosis of peripheral lung lesions. However, the accuracy of ENB navigation suggests that the addition of fluoroscopy is redundant.

ObjectivesData was prospectively collected to determine the yield of ENB without fluoroscopy in the diagnosis of peripheral lung lesions.

MethodENB was performed via flexible bronchoscopy using the superDimension/Bronchus system. Biopsies were taken through the extended working channel after navigation. Fluoroscopy was not utilized, but post transbronchial biopsy chest x-rays were done to exclude pneumothorax. The primary endpoint was diagnostic yield and the secondary endpoints were navigation accuracy, procedure duration and safety. Analysis by lobar distribution was also done to assess the performance in different lobes of the lung.

ResultsNinety-two peripheral lung lesions were biopsied in the 89 subjects. The diagnostic yield of ENB was 67%, which was independent of lesion size. Total procedure time ranged from 16.3 to 45.0 minutes with a mean of 26.9 ± 6.5 minutes. The mean navigation error was 9 ± 6 mm; range 1 to 31. There were two incidences of pneumothorax for which no intervention was required. When analyzed by lobar distribution, there was a trend towards a higher ENB yield in diagnosing lesions in the right middle lobe (88%).

ConclusionsENB can be used as a stand-alone bronchoscopic technique without compromising diagnostic yield or increasing pneumothorax risk. This may result in sizable timesaving and avoids radiation exposure.

Key Words: Electromagnetic Navigation Bronchoscopy • Peripheral lung lesion • Solitary pulmonary nodule • Transbronchial lung biopsy

This article has been cited by other articles:

				D. Makris and K. I. Gourgoulianis Electromagnetic Navigation Diagnostic Bronchoscopy and Transbronchial Biopsy Chest, March 1, 2008; 133(3): 829 - 830. [Full Text] [PDF]