Electromagnetic navigation bronchoscopy: clinical utility in the diagnosis of lung cancer

Abstract

Electromagnetic navigation bronchoscopy (ENB) is one of several technological advances which have broadened the indications for bronchoscopy in the diagnostic workup of lung cancer. The technique facilitates bronchoscopic sampling of peripheral pulmonary nodules as well as mediastinal lymph nodes, although wide availability and expertise in endobronchial ultrasonography has limited its application in routine clinical practice to the former. ENB in this setting is quite versatile and may be considered an established alternative to more invasive techniques, especially in selected patients with underlying pulmonary disease or comorbidities at high risk for complications from computer topography-guided fine needle aspiration or surgical resection. Nodule sampling may be performed with a variety of instruments, including forceps, cytology brushes, and transbronchial needles. Although samples are generally small, they are often suitable for molecular analysis.

Electromagnetic navigation bronchoscopy to access lung lesions in 1,000 subjects: first results of the prospective, multicenter NAVIGATE study

“…All ENB procedures use the superDimension™ navigation system [ 8 , 9 ] version 6.0 or higher (Medtronic, Minneapolis, MN) per product instructions and institutional standard practice. All complementary tools and procedures, including choice of catheter and biopsy tools, order of biopsy tool use, and strategy for staging and diagnostic bronchoscopy were performed at clinician discretion and were captured prospectively for data analysis.…”

Comparison of computed tomographic imaging-guided hook wire localization and electromagnetic navigation bronchoscope localization in the resection of pulmonary nodules: a retrospective cohort study

“…Electromagnetic navigation bronchoscope (ENB) could reach further peripheral lung compared to conventional electronic bronchoscopy 4 , 5 . Combined with the path constructed by ENB, we can mark the location of small pulmonary nodules.…”

Competence in navigation and guided transbronchial biopsy for peripheral pulmonary lesions

“…Sedation EBN is carried out in the vast majority of cases under moderate (intravenous opioids + benzodiazepines) or deep sedation, as constant motion, rapid breathing, and coughing can compromise adequate navigation and/or sampling, while the duration of EBN, significantly longer that of conventional bronchoscopy, would require a very high patient's tolerance. 43 In the largest study published to date, approximately 80% of the patients underwent the procedure under general anesthesia. 31 No head-to-head comparison of safety and yield of EBN performed under moderate or deep sedation is available in the literature.…”