Robot-Assisted Bronchoscopy for Lung Nodule Diagnosis: A Pilot Feasibility Study

Chaddha, Udit; Kovacs, Stephen P.; Manley, Christopher; Shende, Manisha; Murgu, Septimiu; Hogarth, D. Kyle

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a1266

Cited by 3 publications

(2 citation statements)

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“… 10 rEBUS can also only provide a lateral view and not a forward-looking view; thus, rEBUS cannot determine the directionality of the target lesion. Although abstract reports of robotic bronchoscopy have observed rEBUS-confirmed localization success rates of 92% to 96%, 30 – 32 localization success by rEBUS is not equivalent to diagnostic yield, especially since eccentric rEBUS views in up to 50% of cases 30 , 32 are associated with significantly lower diagnostic yield. 33 , 34 A published paper of the Ion robotic platform reported early performance data through 6 months in 29 subjects, with malignant samples in 51.7%, benign samples in 27.6%, and inconclusive results in 20.7% for an early diagnostic yield trend of 79.3%.…”

Section: Discussionmentioning

confidence: 92%

Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction

Pritchett

Bhadra

Mattingley

2020

Journal of Bronchology &Amp; Interventional Pulmonology

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Background: Electromagnetic navigation bronchoscopy (ENB) aids in lung lesion biopsy. However, anatomic divergence between the preprocedural computed tomography (CT) and the actual bronchial anatomy during the procedure can limit localization accuracy. An advanced ENB system has been designed to mitigate CT-to-body divergence using a tomosynthesis-based software algorithm that enhances nodule visibility and allows for intraprocedural local registration. Materials and Methods: A prospective, 2-center study was conducted in subjects with single peripheral lung lesions ≥10 mm to assess localization accuracy of the superDimension navigation system with fluoroscopic navigation technology. Three-dimensional accuracy was confirmed by cone-beam computed tomography. Complications were assessed through 7 days. Results: Fifty subjects were enrolled (25 per site). Lesions were <20 mm in 61.2% (30/49). A bronchus sign was present in 53.1% (26/49). Local registration was completed in 95.9% (47/49). Three-dimensional target overlap (primary endpoint) was achieved in 59.6% (28/47) and 83.0% (39/47) before and after location correction, respectively. Excluding subjects with unevaluable video files, target overlap was achieved 68.3% (28/41) and 95.1% (39/41), respectively. Malignant results were obtained in 53.1% (26/49) by rapid on-site evaluation and 61.2% (30/49) by final pathology of the ENB-aided sample. Diagnostic yield was not evaluated. Procedure-related complications were pneumothorax in 1 subject (no chest tube required) and scant hemoptysis in 3 subjects (no interventions required). Conclusion: ENB with tomosynthesis-based fluoroscopic navigation improved the 3-dimensional convergence between the virtual target and actual lung lesion as confirmed by cone-beam computed tomography. Future studies are necessary to understand the impact of this technology on diagnostic yield.

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Section: Discussionmentioning

confidence: 92%

Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction

Pritchett

Bhadra

Mattingley

2020

Journal of Bronchology &Amp; Interventional Pulmonology

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“…A preliminary multicenter pilot study presented in abstract form on the Monarch™ Platform (BENEFIT; Auris Surgical Robotics, Redwood City, CA) demonstrated that lesion localization was confirmed with rEBUS in 22/24 (91.7%) patients (10) while a larger retrospective abstract including 82 patients Editorial Section of Interventional Pulmonology Virtual or reality: divergence between preprocedural computed tomography scans and lung anatomy during guided bronchoscopy respectively. The pneumothorax rate was reported at 4.8% and bleeding was reported in 3.6% (11). A peer-reviewed feasibility first-in-human study reported tissue acquisition 93% (14/15) (4), but did not use rEBUS or electromagnetic navigation, only visual navigation.…”

Section: Introductionmentioning

confidence: 99%

Virtual or reality: divergence between preprocedural computed tomography scans and lung anatomy during guided bronchoscopy

Pritchett¹,

Bhadra²,

Calcutt³

et al. 2020

J Thorac Dis

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Guided bronchoscopy offers a minimally invasive and safe method for accessing indeterminate pulmonary nodules. However, all current guided bronchoscopy systems rely on a preprocedural computed tomography (CT) scan to create a virtual map of the patient's airways. Changes in lung anatomy between the preprocedural CT scan and the bronchoscopy procedure can lead to a divergence between the expected and actual location of the target lesion. Termed "CT-to-body divergence", this effect reduces diagnostic yield, adds time to the procedure, and can be challenging for the operator. The objective of this paper is to describe the concept of CT-to-body divergence, its contributing factors, and methods and technologies that might minimize its deleterious effects on diagnostic yield.

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Technical Validation of Multi-Section Robotic Bronchoscope With First Person View Control for Transbronchial Biopsies of Peripheral Lung

Masaki

King

Kato

et al. 2021

IEEE Trans. Biomed. Eng.

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Robot-Assisted Bronchoscopy for Lung Nodule Diagnosis: A Pilot Feasibility Study

Cited by 3 publications

References 0 publications

Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction

Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction

Virtual or reality: divergence between preprocedural computed tomography scans and lung anatomy during guided bronchoscopy

Technical Validation of Multi-Section Robotic Bronchoscope With First Person View Control for Transbronchial Biopsies of Peripheral Lung

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