Usefulness of ultrathin bronchoscopy in diagnosis of lung cancer

Novel thin bronchoscope with a 1.7-mm working channel for peripheral pulmonary lesions

“…Although the application of a thin bronchoscope in adults is not a novel idea [8,17], only a few small studies have addressed the role of thin bronchoscopy for evaluating localised peripheral pulmonary lesions [4,6,[18][19][20]. The 3.3-mm thin bronchoscope (BF-3C40) was reportedly a useful adjunct to conventional bronchoscopy in the diagnosis of peripheral pulmonary lesions [4].…”

“…Unfortunately, TBB using the BF-3C40 and biopsy forceps for a 1.2-mm working channel was not performed in that study, so the role of thin bronchoscopy alone was not assessed. Another study using a 2.8-mm ultrathin bronchoscope with a 1.2-mm working channel demonstrated that TBB under fluoroscopic guidance using an ultrathin bronchoscope provided a higher diagnostic yield than that using a standard bronchoscope (60% versus 54%) [6]. YAMAMOTO et al [6] described ultrathin bronchoscopy only as a useful adjunct to but not an alternative to conventional bronchoscopy, because sufficient material for the histological specimen cannot always be obtained with forceps for a 1.2-mm working channel.…”

“…Another study using a 2.8-mm ultrathin bronchoscope with a 1.2-mm working channel demonstrated that TBB under fluoroscopic guidance using an ultrathin bronchoscope provided a higher diagnostic yield than that using a standard bronchoscope (60% versus 54%) [6]. YAMAMOTO et al [6] described ultrathin bronchoscopy only as a useful adjunct to but not an alternative to conventional bronchoscopy, because sufficient material for the histological specimen cannot always be obtained with forceps for a 1.2-mm working channel. Most of the thin bronchoscopes now available incorporate a 1.2-mm working channel, and various instruments, such as biopsy forceps or a cytology brush, which can be passed through the 1.2-mm working channel, are available.…”

“…However, transbronchial biopsy (TBB) using currently available biopsy forceps for the 1.2-mm working channel was not performed in that study; the role of the thin bronchoscope as a single method for diagnosing peripheral pulmonary lesions therefore remains unclarified. In addition, several investigators have indicated that the smallcalibre working channel (1.2 mm) of now-available thin bronchoscopes is limited by insufficient specimen collection [5][6][7]. Therefore, the clinical application of thin bronchoscopy for the examination of peripheral pulmonary lesions in adult patients has been quite limited.…”

Deformable Registration of Bronchoscopic Video Sequences to CT Volumes with Guaranteed Smooth Output

“…However, the actual clinical relevance of ultrathin bronchoscopes is low, as those have not yet proven diagnostic advantages over conventional bronchoscopes [10,11] and do not provide any steering mechanism. Also, Soper et al only considered comparatively simple trajectories consisting of one smooth, one-way motion from the trachea into the peripheral lung.…”