Virtual bronchoscopic navigation as an aid to CT‐guided transbronchial biopsy improves the diagnostic yield for small peripheral pulmonary lesions

Abstract

Combining VBN with CT-TBB significantly improved the diagnostic yield for small PPL.

Does virtual bronchoscopic navigation improve the diagnostic yield of transbronchial biopsy?

“…reported that concomitant use of VBN in bronchoscopy of 3 cm or smaller peripheral lesions using a 2.8‐mm ultrathin bronchoscope and X‐ray fluoroscopy increased the diagnostic yield from 59.9% to 67.1%. However, the increase was not significant and the diagnostic yield of lesions located in the peripheral one‐third of the lung was significantly improved in sub‐analysis, as also reported in the current study …”

“…In sub‐analysis of the data collected by combination with EBUS‐GS, VBN significantly increased the diagnostic yield of CT‐BS‐positive lesions smaller than 2 cm from 70.7% to 94.6%, although these findings cannot be directly compared with that of the present study . Furthermore, Oki et al .…”

“…3 The greater diagnostic yield of peripheral pulmonary lesions using bronchoscopy with VBN is therefore significant; there is no need for an expensive disposable electromagnetic sensor as is the case for electromagnetic navigation (EMN), and it can be easily performed.In a recent publication in Respirology, Kato et al present a randomized controlled study demonstrating that VBN increases the diagnostic yield for CT-guided transbronchial biopsy (CT-TBB). 5 The study focused on patients with CT-bronchus sign (CT-BS)-positive lesions, which were smaller than 2 cm with a low diagnostic yield on conventional bronchoscopy and located in the peripheral one-third of the lung. In this study, the use of VBN for CT-TBB significantly improved the diagnostic yield, which reached 84%.Two other randomized controlled trials of VBN have been performed.…”

“…In a recent publication in Respirology, Kato et al present a randomized controlled study demonstrating that VBN increases the diagnostic yield for CT-guided transbronchial biopsy (CT-TBB). 5 The study focused on patients with CT-bronchus sign (CT-BS)-positive lesions, which were smaller than 2 cm with a low diagnostic yield on conventional bronchoscopy and located in the peripheral one-third of the lung. In this study, the use of VBN for CT-TBB significantly improved the diagnostic yield, which reached 84%.…”

“…However, the increase was not significant and the diagnostic yield of lesions located in the peripheral one-third of the lung was significantly improved in sub-analysis, 7 as also reported in the current study. 5 Therefore, VBN increases the diagnostic yield of small peripheral pulmonary lesions. A key question is with what technique should VBN be combined?…”