Robotic bronchoscopy and future directions of interventional pulmonology

Folch, Erik; Mittal, Abhinav; Oberg, Catherine L.

doi:10.1097/mcp.0000000000000849

Cited by 15 publications

(11 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Initially in human cadavers, the PRECISE‐1 study reported a 100% rate of target localization and 80% of successful nodule puncture, both superior to EMB guidance and ultrathin bronchoscopy, 16 with similar rates reported by Chen et al 15 Recent human studies found comparable successful navigation, ranging from 88% to 98% using either EMB or shape‐sensing technology 24,25 . Reported diagnostic yield for RAB with or without R‐EBUS ranges from 69.1% to 88% 24,26–29 . We achieved a 100% rate of efficacy to reach and sample the target nodule, and an overall diagnostic yield of 87.6% for RAB.…”

Section: Discussionsupporting

confidence: 64%

See 1 more Smart Citation

Robotic‐assisted bronchoscopy versus CT‐guided transthoracic biopsy for diagnosis of pulmonary nodules

et al. 2022

View full text Add to dashboard Cite

Background and Objective Currently, computed tomography‐guided transthoracic biopsy (CTTB) is the most accurate diagnostic approach for pulmonary nodules suspected of malignancy. Traditional bronchoscopy has shown suboptimal diagnostic sensitivity, but the emergence of robotic‐assisted bronchoscopy (RAB) has the potential to improve diagnostic accuracy, maximize diagnostic yield and complete mediastinal and hilar staging in a single procedure. We aim to assess the efficacy and diagnostic performance of RAB compared to CTTB for diagnosing pulmonary nodules suspected of lung cancer. Methods A multicenter retrospective review of consecutive patients who underwent RAB and CTTB for evaluating pulmonary nodules from January 2019 to March 2021 at Mayo Clinic Florida and Mayo Clinic Rochester, United States. Clinical and demographic information, nodule characteristics, outcomes and complications were compared between RAB and CTTB. Results A total of 225 patients were included: 113 in the RAB group and 112 in the CTTB group. Overall diagnostic yield was 87.6% for RAB and 88.4% for CTTB. For malignant disease, RAB had a sensitivity of 82.1% and a specificity of 100%, CTTB had a sensitivity of 88.5% and a specificity of 100%. Complication rate was significantly higher for CTTB compared to RAB (17% vs. 4.4%; p = 0.002). Conclusion RAB, when available, can be as accurate as CTTB for sampling pulmonary nodules with similar or reduced complications and should be considered as a means for nodule biopsy, particularly when mediastinal staging is also clinically warranted.

show abstract

Section: Discussionsupporting

confidence: 64%

“…24,25 Reported diagnostic yield for RAB with or without R-EBUS ranges from 69.1% to 88%. 24,[26][27][28][29] We achieved a 100% rate of efficacy to reach and sample the target nodule, and an overall diagnostic yield of 87.6% for RAB.…”

Section: Discussionmentioning

confidence: 93%

Robotic‐assisted bronchoscopy versus CT‐guided transthoracic biopsy for diagnosis of pulmonary nodules

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Robotic-assisted bronchoscopy is the newest technology available to biopsy peripheral pulmonary nodules (PPN). The Ion robotic system (Intuitive Surgical, Sunnyvale, CA) utilizes proprietary shape-sensing technology for navigation to PPN, including those which are extraluminal and/or abutting the pleural surface [ 3 ]. While a recent study reported lesion localization of 97% [ 4 ], diagnostic yields remain lower at 83% [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Novel Robotic-Assisted Cryobiopsy for Peripheral Pulmonary Lesions

Oberg

Folch

et al. 2022

Lung

View full text Add to dashboard Cite

Purpose Tissue acquisition in lung cancer is vital for multiple reasons. Primary reasons reported for molecular testing failure in lung cancer biopsy specimens include insufficient amount of tumor cells provided and inadequate tissue quality. Robotic bronchoscopy is a new tool enabling peripheral pulmonary lesion sampling; however, diagnostic yield remains imperfect possibly due to the location of nodules adjacent to or outside of the airway. The 1.1-mm cryoprobe is a novel diagnostic tool and accesses tissue in a 360-degree manner, thus potentially sampling eccentric/adjacent lesions. This study examines the diagnostic yield of the cryoprobe compared to standard needle aspiration and forceps biopsy. It additionally evaluates yield for molecular markers in cases of lung cancer. Methods This is a retrospective analysis of 112 patients with 120 peripheral pulmonary lesions biopsied via robotic bronchoscopy using needle aspirate, forceps, and cryobiopsy. Results The overall diagnostic yield was 90%. Nearly 18% of diagnoses were made exclusively from the cryobiopsy sample. Molecular analysis was adequate on all cryobiopsy samples sent. Digital imaging software confirmed an increase in quantity and quality of samples taken via cryobiopsy compared to needle aspirate and traditional forceps biopsy. Conclusion Using the 1.1-mm cryoprobe to biopsy PPN combined with the Ion robotic bronchoscopy system is safe, feasible, and provides more diagnostic tissue than needle aspirates or traditional forceps biopsies. The combination of cryobiopsy with robotic-assisted bronchoscopy increased diagnostic yield, likely due to its 360-degree tissue acquisition which is beneficial when targeting extraluminal lesions adjacent to the airway.

show abstract

“…The recent advances in bronchoscopic navigation and robotic-assisted navigation have made it possible to successfully reach the intended target. 63 64 The complementary use of confirmatory technologies such as cone-beam CT, 3D fluoroscopy or CT-fluoroscopy has provided the much-sought reassurance of the position of the probe relative to the tumor. These advanced navigation platforms have also allowed us to remain in position for the duration of the ablation.…”

Section: What Are the Next Steps Necessary For Bronchoscopic Ablation?mentioning

confidence: 99%

Therapeutic Bronchoscopy for Lung Nodules: Where Are We Now?

Folch

Guo

Senitko

2022

Semin Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

Lobar resection has been the established standard of care for peripheral early-stage non—small cell lung cancer (NSCLC). Over the last few years, surgical lung sparing approach (sublobar resection [SLR]) has been compared with lobar resection in T1N0 NSCLC. Three nonsurgical options are available in those patients who have a prohibitive surgical risk, and those who refuse surgery: stereotactic body radiotherapy (SBRT), percutaneous ablation, and bronchoscopic ablation. Local ablation involves placement of a probe into a tumor, and subsequent application of either heat or cold energy, pulsing electrical fields, or placement of radioactive source under an image guidance to create a zone of cell death that encompasses the targeted lesion and an ablation margin. Despite being in their infancy, the bronchoscopic ablative techniques are undergoing rapid research, as they extrapolate a significant knowledge-base from the percutaneous techniques that have been in the radiologist's armamentarium since 2000. Here, we discuss selected endoscopic and percutaneous thermal and non-thermal therapies with the focus on their efficacy and safety.

show abstract

Robotic bronchoscopy and future directions of interventional pulmonology

Cited by 15 publications

References 38 publications

Robotic‐assisted bronchoscopy versus CT‐guided transthoracic biopsy for diagnosis of pulmonary nodules

Robotic‐assisted bronchoscopy versus CT‐guided transthoracic biopsy for diagnosis of pulmonary nodules

Novel Robotic-Assisted Cryobiopsy for Peripheral Pulmonary Lesions

Therapeutic Bronchoscopy for Lung Nodules: Where Are We Now?

Contact Info

Product

Resources

About