Abstract
Introduction
Diagnostic bronchoscopy for peripheral pulmonary lesions (PPLs) requires selection of the correct bronchus leading to the target lesion. Usually, we need to manually trace the endobronchial route using 2-dimensional CT images but this is not always easy. To support this, we have been using Ziostation2®, a visualization and analysis platform that can be accessed easily from a hospital server, to reconstruct a 3-dimensional simulation map (SM) from multi-planar reconstruction (MPR) CT images. This SM was prepared prior to every bronchoscopy procedure and used as a guide to locate the target lesion.
Methods
To examine the benefits of Ziostation2® map, we compared the ultrasound detection rates, diagnostic yields, and procedure times between two groups of patients who underwent bronchoscopy for diagnosis of PPLs. The SM group included 142 consecutive patients with Ziostation2® maps from late June 2013 to October 2013 while the non-SM group included 148 consecutive patients without any navigation from November 2012 to early June 2013. We excluded cases without thin-slice CT and those without a definitive diagnosis in the follow-up period.
Results
The SM group had significantly higher ultrasound detection rate (96.5% vs. 84.9%; p=0.0128), and shorter procedure time [21 (range 11-43) minutes vs. 23 (range 12-45) minutes; (p=0.0046)]. Although not significant, the diagnostic yield tended to be higher in the SM group compared to the non-SM group (82.4% vs. 77.0%; p=0.2564), and was affected by ultrasound detection rate (p<0.0001).
Conclusion
At no additional cost, simulation map by Ziostation2® is a valuable tool that facilitates a more accurate and faster bronchoscopy procedure for diagnosis of PPLs.
- © 2014 ERS
