Endobronchial treatment of peripheral tumors: ongoing development and perspectives

Vieira, T.; Stern, Jean‐Baptiste; Girard, Philippe; Caliandro, R.

doi:10.21037/jtd.2018.01.86

Cited by 12 publications

(13 citation statements)

References 27 publications

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“…Toward completion of device development and implementation, we envision deep lung catheter-based ultrasound devices ($2 mm OD) deployed through the working channel of a flexible bronchoscope, and positioned at the target site under real-time steering and guidance using CT-based electromagnetic navigation methods typical of radial endobronchial ultrasonography in peripheral lung [78]. The ultrasound ablation can be performed once the water-coupling balloon is inflated, and at completion the device can be deflated and withdrawn.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, flexible or rigid video bronchoscopes with larger bores can facilitate placement of larger ultrasound devices (5-10 mm OD) in the larger upper airways, following similar techniques currently applied for interventions ablating obstructing tumors in the trachea and bronchus. These procedures could be via trans-nasal or oral bronchoscopic introduction, while under procedural sedation or general anesthesia, following approaches common to interventional pulmonology [78]. Post-ablation monitoring and evaluation could be performed using CT, PET, and/or MRI based imaging techniques [79].…”

Section: Discussionmentioning

confidence: 99%

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Endobronchial high-intensity ultrasound for thermal therapy of pulmonary malignancies: simulations with patient-specific lung models

Liu

Adams

Diederich

2019

International Journal of Hyperthermia

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Objective: This study investigates the feasibility of endobronchial ultrasound applicators for thermal ablation of lung tumors using acoustic and biothermal simulations. Methods: Endobronchial ultrasound applicators with planar (10 mm width) or tubular transducers (6 mm outer diameter (OD)) encapsulated by expandable coupling balloons (10 mm OD) are considered for treating tumors from within major airways; smaller catheter-based applicators with tubular transducers (1.7-4 mm OD) and coupling balloons (2.5-5 mm OD) are considered within deep lung airways. Parametric studies were applied to evaluate transducer configurations, tumor size and location, effects of acoustic reflection and absorption at tumor-lung parenchyma interfaces, and the utility of lung flooding for enhancing accessibility. Patient-specific anatomical lung models, with various geometries and locations of tumors, were developed for further evaluation of device performance and treatment strategies. Temperature and thermal dose distributions were calculated and reported. Results: Large endobronchial applicators with planar or tubular transducers (3-7 MHz, 5 min) can thermally ablate tumors attached to major bronchi at up to 3 cm depth, where reflection and attenuation of normal lung localize tumor heating; with lung flooding, endobronchial applicators can ablate $2 cm diameter tumors with up to $2 cm separation from the bronchial wall, without significant heating of intervening tissue. Smaller catheter-based tubular applicators can ablate tumors up to 2-3 cm in diameter from deep lung airways (5-9 MHz, 5 min). Conclusion: Simulations demonstrate the feasibility of endobronchial ultrasound applicators to deliver thermal coagulation of 2-3 cm diameter tumors adjacent to or accessible from major and deep lung airways.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endobronchial high-intensity ultrasound for thermal therapy of pulmonary malignancies: simulations with patient-specific lung models

Liu

Adams

Diederich

2019

International Journal of Hyperthermia

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“…However, in direct comparisons with SBRT in compromised patients, sublobar is consistently shown to deliver better oncological outcomes and survival, whilst causing no more morbidity . Thermal ablation of lung tumours has also been described using radiofrequency or microwave energy and can be delivered via percutaneous or endobronchial approaches . However, these have so far been performed in relatively small numbers under clinical trial settings, and it may be a number of years before sufficient data is accumulated to define their usefulness for patients.…”

Section: Is Sublobar Resection Surgery the Ideal Intervention For Ggos?mentioning

confidence: 99%

“…Note the pulmonary artery segmental branches to the target segments have been divided with vascular clips applied to the stumps (black arrow) or endobronchial approaches. 52,53 However, these have so far been performed in relatively small numbers under clinical trial settings, and it may be a number of years before sufficient data is accumulated to define their usefulness for patients.…”

Section: Is Sublobar Resection Surgery the Ideal Intervention For Gmentioning

confidence: 99%

Surgical management of ground glass opacities of the lung

Sihoe¹

2020

Surgical Practice

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Emerging evidence for the efficacy of low‐dose CT thorax screening for lung cancer is undoubtedly good news for patients. However, the by‐product is increasing incidental detection of lung lesions know as ground‐glass opacities (GGOs). Because these may or may not develop into lung cancer, a number of guidelines currently exist to help clinicians decide how to manage them. These guidelines are characterized by a reliance on CT imaging alone, an inherent aversion to surgery, and a failure to recognize the possibility of variance in GGO pathology between populations in different parts of the world. As a result, surgeons in particular are inadequately served by these guidelines. This article explores how recent advanced in thoracic surgery may play important roles in shaping GGO management, and how surgery may need to feature more prominently in future guidelines.

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“…Previous studies have showed that electromagnetic navigation could ease the surgeon's work, reduce complications and minimizes surgery time [9,11]. It is also used for placement of fiducial markers for stereotactic radiotherapy and accurate navigation to target lesions [12].…”

Section: Introductionmentioning

confidence: 99%

Effect of Electromagnetic Navigation System Assisted Percutaneous Full-endoscopic Foraminoplasty and Discectomy on Lumbar Disc Herniation: A Randomized Controlled Trial

Yang¹,

Rao²,

Li³

et al. 2020

Preprint

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Background Electromagnetic navigation-guided technique is an exciting innovative procedure, which has been applied in neurosurgery, otolaryngology, oral and maxillofacial surgery, etc. However, no previous study of the application of electromagnetic navigation to guide endoscopic surgery of disc herniation has been reported. Here, we introduce a new technique of electromagnetic navigation system assisted percutaneous full-endoscopic lumbar foraminoplasty and discectomy and compare it to conventional TESSYS technique. Methods This is a prospective, randomized controlled trial. The observation group was treated with SEESSYS, and the control group was treated with the traditional Transforaminal Endoscopic Spinal Surgery System (TESSYS). Overall surgical time and fluoroscopy time were recorded in all cases. Outcomes of symptoms were evaluated by Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI), and modified MacNab criteria (excellent, good, fair and poor). Results 34 patients (SEESSYS, 17 patients; TESSYS, 17 patients) were enrolled in this study. Both overall surgical time and working tube introduction time were significantly shorter in SEESSYS group than that in TESSYS group (P<0.01). The fluoroscopy time in SEESSYS group was significantly less than that in TESSYS group (P<0.01). Back VAS, leg VAS and ODI at each time point after surgery were not significantly different between two groups (P > 0.05). In both the SEESSYS and TESSYS group, there was a significant decrease in back VAS, leg VAS and ODI at each time point after surgery compared with pre-operation respectively (P<0.01). The excellent and good rate of SEESSYS group was 95%, which is similar to the 90% in TESSYS group. Conclusions Electromagnetic navigation system assisted percutaneous full-endoscopic foraminoplasty and discectomy may be a safe and effective method for treating lumbar disc herniation and this method has the advantages of shortening operative time and fluoroscopy time compared with conventional TESSYS technique. Trial registration The study was registered at Chinese Clinical Trail Registry on Feb 06, 2020 with the registration number: ChiCTR2000029604. (http://www.chictr.org.cn/showproj.aspx?proj=49149)

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Endobronchial treatment of peripheral tumors: ongoing development and perspectives

Cited by 12 publications

References 27 publications

Endobronchial high-intensity ultrasound for thermal therapy of pulmonary malignancies: simulations with patient-specific lung models

Endobronchial high-intensity ultrasound for thermal therapy of pulmonary malignancies: simulations with patient-specific lung models

Surgical management of ground glass opacities of the lung

Effect of Electromagnetic Navigation System Assisted Percutaneous Full-endoscopic Foraminoplasty and Discectomy on Lumbar Disc Herniation: A Randomized Controlled Trial

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