RT Journal Article
SR Electronic
T1 Effect of virtual bronchoscopic navigation in combination with ultrathin bronchoscopy for diagnosing peripheral pulmonary lesions
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2310
VO 42
IS Suppl 57
A1 Naofumi Shinagawa
A1 Fumihiro Asano
A1 Takashi Ishida
A1 Joe Shindoh
A1 Masaki Anzai
A1 Akifumi Tsuzuku
A1 Satoshi Oizumi
A1 Satoshi Morita
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P2310.abstract
AB Background: We have previously shown the usefulness of virtual bronchoscopic navigation (VBN) for diagnosing peripheral pulmonary nodules using endobronchial ultrasound. Ultrathin bronchoscope can be inserted to more peripheral bronchi, and VBN can guide bronchoscope insertion. However, the usefulness of the combination of VBN and ultrathin bronchoscopy has not yet been confirmed.Objectives: We performed prospective multicenter study to evaluate the value of VBN-assisted ultrathin bronchoscopy for diagnosing small peripheral pulmonary lesions.Methods: We randomly assigned 350 patients with small peripheral pulmonary lesions <30 mm in diameter which suspected to lung cancer to VBN-assisted or non-VBN-assisted groups. An ultrathin bronchoscope was inserted to the target bronchus following a VBN system in the VBN-assisted group. Biopsy and/or brushing from lesions were performed under X-ray fluoroscopy.Results: The diagnostic yield was higher in the VBN-assisted group (67.1%) than in the non-VBN-assisted group (59.9%), but the difference was not significant (p = 0.173). The subgroup analysis showed that the diagnostic yield was significantly higher in the VBN-assisted group than in the non-VBN-assisted group for right upper lobe lesions (81.3% vs. 53.2%, p = 0.004), lesions invisible on P-A X-ray films (63.2% vs. 40.5%, p = 0.043), and lesions in the peripheral third of the lung field (64.7% vs. 52.1%, p = 0.047).Conclusions: Combination of VBN and ultrathin bronchoscopy is useful for diagnosing lesions in the right upper lobe, lesions invisible on P-A X-ray films, and lesions in the peripheral third of the lung field.