Diagnostic yield of electromagnetic navigational bronchoscopy: results of initial 35 cases in a Japanese institute

Satô, Toshihiko; Yutaka, Yojiro; Ueda, Yuichiro; Hamaji, Masatsugu; Motoyama, Hideki; Menju, Toshi; Aoyama, Akihiro; Chen‐Yoshikawa, Toyofumi F.; Sonobe, Makoto; Date, Hiroshi

doi:10.21037/jtd.2018.04.123

Cited by 13 publications

(5 citation statements)

References 11 publications

(13 reference statements)

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“…On the contrary, the majority of the ENB procedures were performed under sedation. This was similar to the experience of Sato et al [20]. Interestingly Bertoletti et al used an inhalational mixture of a 50/50 combination of nitrous oxide/oxygen for performing ENB and found that to be efficacious and well tolerated [21].…”

Section: Discussionsupporting

confidence: 80%

CT-Guided vs. Navigational Bronchoscopic Biopsies for Solitary Pulmonary Nodules: A Single-Institution Retrospective Comparison

Chaudry,

Thivierge-Southidara,

Molina

et al. 2023

Cancers

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Objective: Lung cancer is the second most common cause of death by cancer. Multiple modalities can be used to obtain a tissue sample from a pulmonary nodule. We aimed to compare the yield and adverse events related to transthoracic needle aspiration (TTNA) and Electromagnetic Navigation Biopsy (ENB) at our institution. Methods: This was a single-center retrospective study in which all patients referred for evaluation of a pulmonary lesion over 5 years (1 January 2013 to 31 December 2018) were identified. Our primary outcome was to compare the accuracy of TTNA to that of ENB in establishing the diagnosis of pulmonary lesions. Secondary outcomes included the evaluation of the adverse events and the sensitivity, specificity, positive, and negative predictive value of each modality. Results: A total of 1006 patients were analyzed. The mean age of patients in the TTNA and the ENB group was 67.2 ± 11.2 years and 68.3 ± 9.2 years respectively. Local anesthesia was predominantly used for TTNA and moderate sedation was more commonly used in the ENB group. We found ENB to have an accuracy of 57.1%, with a sensitivity of 40.0%, a specificity of 100.0%, a positive predictive value of 100.0%, and a negative predictive value of 40.0%. As for the TTNA, the accuracy was 75.9%, with a sensitivity of 77.5%, a specificity of 61.5%, a positive predictive value of 95.0%, and a negative predictive value of 22.5%. The rate of clinically significant complications was higher in the TTNA group (8.2%) as compared to the ENB group (4.7%) with a p-value < 0.001. Conclusion: TTNA was superior to ENB-guided biopsy for the diagnostic evaluation of lung nodules. However, the complication rate was much higher in the TTNA group as compared to the ENB group.

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Section: Discussionsupporting

confidence: 80%

CT-Guided vs. Navigational Bronchoscopic Biopsies for Solitary Pulmonary Nodules: A Single-Institution Retrospective Comparison

Chaudry,

Thivierge-Southidara,

Molina

et al. 2023

Cancers

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“…The high technical success rate was first owed to strict patient selection. Lesions of larger sizes or with bronchus signs would be easier to reach successfully (9,28,29). In this study, biopsy results came back positive for malignancy for all three nodules sized 2-3 cm.…”

Section: Discussionsupporting

confidence: 49%

Electromagnetic bronchoscopy guided microwave ablation for early stage lung cancer presenting as ground glass nodule

Bao¹,

Yu²,

Wang³

et al. 2021

Transl Lung Cancer Res

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Background: Patients with early-stage lung cancer are sometimes medically inoperable, and for patients with multiple primary lung cancers, surgical resection alone sometimes proves to be impractical. Local treatments like microwave ablation (MWA) are investigational alternatives for these patients. Most reported MWA procedures for lung cancers are performed percutaneously under CT guidance. MWA navigated by electromagnetic bronchoscopy (ENB) has been limitedly studied. In this study, we aimed to evaluate the safety and feasibility of MWA under ENB guidance in patients with inoperable early-stage lung cancers or multiple primary lung cancers which cannot be completely resected.Methods: From June 2019 to December 2020, preliminary attempts of ENB-guided MWA were made in five medically inoperable patients with a single early-stage lung cancer and ten patients with multiple primary lung cancers which were difficult to resect at the same time. For patients with concomitant pulmonary nodules which needed surgical resection, thoracoscopic resections were performed following ENB-guided MWA. The safety, feasibility, and technique effectiveness of treatments were evaluated.Results: ENB-guided MWA for 15 ground glass nodules (GGNs) in 15 patients was completed in accordance with the planned protocol. Biopsy of 13 GGNs showed malignancy. Five patients received simple ENB-guided MWA without simultaneous surgical resection and ten patients received simultaneous surgical resection for 13 concomitant pulmonary nodules. CT scan by the first postoperative week showed technique effectiveness of ablation for 11 nodules indicated for MWA. Four patients had mild complications after the procedure and recovered shortly after treatment.Conclusions: For medically inoperable patients with a single GGN manifesting early-stage lung cancer and patients with multiple primary early-stage lung cancers which cannot be resected at the same time, ENB-guided MWA might be a safe and feasible alternative local treatment, whether combined with surgical resection or not. However, large, prospective, randomized, multicenter studies are needed to confirm its role in the treatment of early-stage lung cancer.

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“…There are also adverse effects such as pneumothorax requiring intervention (1-15%), pulmonary hemorrhages (18%) and hemoptysis (4.1%) [3,5,6]. While the adverse effects are less with ENB (pneumothorax 3.2%, pulmonary hemorrhage 2.3%), and the overall diagnostic yield ranges from 59-77%, it is a technically challenging procedure without the ability to directly visualize the target [7,8].…”

Section: Introductionmentioning

confidence: 99%

Lung Nodule Evaluation Using Robotic-Assisted Bronchoscopy at a Veteran’s Affairs Hospital

Ekeke

Vercauteren

Istvaniczdravkovic

et al. 2021

JCM

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The incidence of lung nodules has increased with improved diagnostic imaging and screening protocols. Despite improvements for diagnosing pulmonary nodules with technologies such as electromagnetic navigational bronchoscopy (ENB), several limitations still exist including adequate visualization, localization, and diagnostic yield. Robotic-assisted bronchoscopy with ENB has been introduced as a method to overcome these shortcomings. We describe our initial experience in evaluating lung nodules with robotic assisted bronchoscopy. We retrospectively reviewed data on the first 25 patients that underwent robotic-assisted bronchoscopy and biopsy. We analyzed success with localization, diagnostic yield, and post procedural morbidity. Diagnostic yield was 96% (24/25) with no periprocedural morbidity. The majority of nodules were malignant or atypical (76%) and were located in the right upper lobe. Diameter ranged between 0.8–6.9 cm (median size 1–2 cm). Seventy-five percent of patients underwent subsequent treatment for cancer based on these results, with 25% having continued surveillance. Robotic assisted bronchoscopy is safe and accurate. Studies with larger numbers will allow better understanding of the diagnostic yield and clinical utility of this approach in comparison to other diagnostic tools for lung nodules.

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Diagnostic yield of electromagnetic navigational bronchoscopy: results of initial 35 cases in a Japanese institute

Abstract: In our initial series of 35 cases, ENB-guided TBLB showed an acceptable diagnostic yield.

Cited by 13 publications

References 11 publications

CT-Guided vs. Navigational Bronchoscopic Biopsies for Solitary Pulmonary Nodules: A Single-Institution Retrospective Comparison

CT-Guided vs. Navigational Bronchoscopic Biopsies for Solitary Pulmonary Nodules: A Single-Institution Retrospective Comparison

Electromagnetic bronchoscopy guided microwave ablation for early stage lung cancer presenting as ground glass nodule

Lung Nodule Evaluation Using Robotic-Assisted Bronchoscopy at a Veteran’s Affairs Hospital

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