Abstract
Background: Electromagnetic navigation (EN) is a technique that can be used with bronchoscopy to obtain samples of small peripheral nodular lesions. It enables both transbronchial biopsies and fine-needle aspiration to be performed. EN can obviate the need for more invasive diagnostic procedures thus saving time and avoiding complications.
Aim: To evaluate the diagnostic yield of electromagnetic navigation-guided bronchoscopy (ENB) in patients with peripheral lung lesions and analyze the results according to the size of the lesion and the presence of a bronchus sign in the computed tomography (CT).
Patients and methods: From April 2009-October2010, 50 consecutive patients were included. We used the Bronchus®system (Superdimension) with a therapeutic bronchoscope (Olympus, working channel 2,8mm). All subjects had CT scans of the chest, configures with slices of 1-2mm thickness at 1-1.5mm intervals in DICOM format.
Results: 70%: male. Median age: 69. The average size of the lesions was 22,6mm [≤20mm: 19 (38%) and >20mm: 31 (62%)]. Mean duration of the intervention: 25mn. Diagnosis rate of this procedure was 67%; 61% for lesions ≤ 20mm in diameter, and 71% if>20mm.The bronchus sign (BS) was identified in 44% patients. In cases with BS, the diagnosis yield increased until 82% and when BS was negative: 54% (statistically significant variable).
Conclusions: FBEN is a safe method that increases the diagnosis yield of peripheral lung lesions. 67% of cases resulted in obtaining diagnostic tissue. If BS was identified, diagnostic yield was statistically significant increased. There was no relation with lesion's size.
- © 2011 ERS