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DOI: 10.1055/s-0033-1342953
Electromagnetic Navigational Bronchoscopy
Publication History
Publication Date:
28 May 2013 (online)
Abstract
Despite advances in technology and treatment options, lung cancer remains a deadly disease. National screening programs are being instituted in an attempt to discover lung cancer in high-risk individuals at an earlier stage. Such screening programs invariably discover small peripheral nodules that previously would not have been clinically apparent; the management of such lesions can be challenging. Current diagnostic options such as percutaneous biopsy are effective; however, they are hindered by their risk of morbidity such as pneumothorax. Electromagnetic bronchoscopy (ENB) is an emerging technology that allows the practitioner the ability to both sample and treat small peripheral pulmonary lesions. In experienced centers, ENB provides high rates of diagnostic yield for small lesions and a complication rate significantly lower than that of more conventional diagnostic modalities. Although there are current barriers to its widespread utilization (cost, specialized imaging, technical training), these obstacles will handled similarly to any other emerging technology and will likely not be long-term impediments to its use.
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References
- 1 Aberle DR, Adams AM, Berg CD , et al; National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011; 365 (5) 395-409
- 2 Henschke CI, McCauley DI, Yankelevitz DF , et al. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 1999; 354 (9173) 99-105
- 3 Hautmann H, Henke MO, Bitterling H. High diagnostic yield from transbronchial biopsy of solitary pulmonary nodules using low-dose CT-guidance. Respirology 2010; 15 (4) 677-682
- 4 Tsushima K, Sone S, Hanaoka T, Takayama F, Honda T, Kubo K. Comparison of bronchoscopic diagnosis for peripheral pulmonary nodule under fluoroscopic guidance with CT guidance. Respir Med 2006; 100 (4) 737-745
- 5 Hiraki T, Mimura H, Gobara H , et al. Incidence of and risk factors for pneumothorax and chest tube placement after CT fluoroscopy-guided percutaneous lung biopsy: retrospective analysis of the procedures conducted over a 9-year period. AJR Am J Roentgenol 2010; 194 (3) 809-814
- 6 Li H, Boiselle PM, Shepard JO, Trotman-Dickenson B, McLoud TC. Diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of the lung: comparison of small and large pulmonary nodules. AJR Am J Roentgenol 1996; 167 (1) 105-109
- 7 Leong S, Ju H, Marshall H , et al. Electromagnetic navigation bronchoscopy: a descriptive analysis. J Thorac Dis 2012; 4 (2) 173-185
- 8 Seijo LM, de Torres JP, Lozano MD , et al. Diagnostic yield of electromagnetic navigation bronchoscopy is highly dependent on the presence of a Bronchus sign on CT imaging: results from a prospective study. Chest 2010; 138 (6) 1316-1321
- 9 Lamprecht B, Porsch P, Pirich C, Studnicka M. Electromagnetic navigation bronchoscopy in combination with PET-CT and rapid on-site cytopathologic examination for diagnosis of peripheral lung lesions. Lung 2009; 187 (1) 55-59
- 10 Wilson DS, Bartlett RJ. Improved diagnostic yield of bronchoscopy in a community practice: combination of electromagnetic navigation system and rapid on-site evaluation. J Bronchol 2007; 14: 227-232
- 11 National Cancer Institute, American College of Surgeons Oncology Group, Radiation Therapy Oncology Group. A randomized phase III study of sublobar resection (+/- brachytherapy) versus stereotactic body radiation therapy in high risk patients with stage i non-small cell lung cancer (NSCLS). In: ACOSOG Protocol Z4099, RTOG Protocol 1021. St. Louis, MO: Washington University School of Medicine; 2011