Virtual bronchoscopic navigation combined with endobronchial ultrasound to diagnose small peripheral pulmonary lesions: a randomised trial

Ishida, Takashi; Asano, Fumihiro; Yamazaki, Koichi; Shinagawa, Naofumi; Oizumi, Satoshi; Moriya, Hideshige; Munakata, Mitsuru; Nishimura, Masaharu

doi:10.1136/thx.2010.145490

Cited by 240 publications

(242 citation statements)

References 36 publications

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“…Furthermore, multiple studies have demonstrated that VB may improve diagnostic performance of radial EBUS [10,30,31]. In centres where these adjunct tools are not utilised, the incremental gain in diagnostic performance with addition of EMN may be greater than observed in our current study.…”

Section: Discussioncontrasting

confidence: 55%

Sequential multimodality bronchoscopic investigation of peripheral pulmonary lesions

et al. 2015

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Multiple guidance modalities may be combined during bronchoscopic investigation of peripheral pulmonary lesions (PPLs). The relative contribution of each modality to diagnostic performance remains uncertain.Endobronchial ultrasound (EBUS) with virtual bronchoscopy (VB) was routinely performed, with electromagnetic navigation (EMN) utilised only where EBUS was unable to locate PPLs or where the probe was adjacent to the lesion and on-site cytologic examination was nondiagnostic.236 consecutive patients with 245 PPLs had lesion size 22.8±12.4 mm (mean±SD). PPLs were localised using EBUS+VB alone in 188 (77%) and was diagnostic in 134 of these (71.3%). EBUS localisation was predicted by PPL size (23.7±10.5 versus 19.7±9.8 mm, p=0.003), but not by bronchus sign, PPL-hilum distance or PPL-pleura distance. EMN in 57 patients achieved EBUS localisation in a further 17 patients (30.9%), improving overall visualisation yield to 85%. Nine of these 57 procedures achieved a definitive diagnosis (16%), improving overall diagnostic yield to 58.4%. Probe position and lesion type influenced overall diagnostic yield. Sensitivity for diagnosis of lung cancer was 70% (131/188; 95% CI 63-76%).Localisation rate and diagnostic sensitivity of radial probe EBUS+VB alone for diagnosis of PPLs is high. EBUS localisation rates and procedural yield are improved only modestly (by 8% and 4%, respectively) with addition of EMN. Sampling following EMN should include all available methods to maximise diagnostic yield. @ERSpublications EMN after nondiagnostic radial EBUS gives only small incremental gain in visualisation rate and diagnostic yield

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Section: Discussioncontrasting

confidence: 55%

Sequential multimodality bronchoscopic investigation of peripheral pulmonary lesions

et al. 2015

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“…Several studies have reported that EBUS-GS with VBN was safe and effective for diagnosing small peripheral lung lesions [22,23]. Furthermore, another study reported that diagnostic yield for small peripheral lung lesions is significantly increased when VBN is added to EBUS-GS [24].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Endobronchial Ultrasonography With a Guide Sheath and Virtual Bronchoscopic Navigation for Ground-Glass Opacity Lesions

Ikezawa

Shinagawa

Sukoh

et al. 2017

The Annals of Thoracic Surgery

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“…107 In this trial, diagnostic yield was higher for the VBN-assisted procedure (80%) than for the unassisted procedure (67%).…”

Section: In the Individual With A Solid Indeterminate Nodule That Shmentioning

confidence: 90%

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Gould

Donington

Lynch

et al. 2013

Chest

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we suggest that no additional diagnostic evaluation need be performed (Grade 2C) .Remark : This recommendation applies only to solid nodules. For guidance about follow-up of subsolid nodules, see Recommendations 6.5.1 to 6.5.4 . 2.3.3.In the individual with an indeterminate nodule that is identifi ed by chest radiography, we recommend that CT of the chest should be performed (preferably with thin sections Objectives: The objective of this article is to update previous evidence-based recommendations for evaluation and management of individuals with solid pulmonary nodules and to generate new recommendations for those with nonsolid nodules. Methods: We updated prior literature reviews, synthesized evidence, and formulated recommendations by using the methods described in the "Methodology for Development of Guidelines for Lung Cancer" in the American College of Chest Physicians Lung Cancer Guidelines, 3rd ed. Results: We formulated recommendations for evaluating solid pulmonary nodules that measure . 8 mm in diameter, solid nodules that measure Յ 8 mm in diameter, and subsolid nodules. The recommendations stress the value of assessing the probability of malignancy, the utility of imaging tests, the need to weigh the benefi ts and harms of different management strategies (nonsurgical biopsy, surgical resection, and surveillance with chest CT imaging), and the importance of eliciting patient preferences. Conclusions: Individuals with pulmonary nodules should be evaluated and managed by estimating the probability of malignancy, performing imaging tests to better characterize the lesions, evaluating the risks associated with various management alternatives, and eliciting their preferences for management. CHEST 2013; 143(5)(Suppl):e93S-e120SAbbreviations: AAH 5 atypical adenomatous hyperplasia; ACCP 5 American College of Chest Physicians; AIS 5 adenocarcinoma in situ; EBUS 5 endobronchial ultrasound; ENB 5 electromagnetic navigation bronchoscopy; FDG 5 fl uorodeoxyglucose; HU 5 Hounsfi eld unit; LR 5 likelihood ratio; SPECT 5 single-photon emission CT; TBB 5 transbronchial biopsy; TTNB 5 transthoracic needle biopsy; VATS 5 video-assisted thoracic surgery; VBN 5 virtual bronchoscopy navigation; VDT 5 volume doubling time

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Virtual bronchoscopic navigation combined with endobronchial ultrasound to diagnose small peripheral pulmonary lesions: a randomised trial

Cited by 240 publications

References 36 publications

Sequential multimodality bronchoscopic investigation of peripheral pulmonary lesions

Sequential multimodality bronchoscopic investigation of peripheral pulmonary lesions

Usefulness of Endobronchial Ultrasonography With a Guide Sheath and Virtual Bronchoscopic Navigation for Ground-Glass Opacity Lesions

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

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