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Virtual bronchoscopic navigation as an aid to CT‐guided transbronchial biopsy improves the diagnostic yield for small peripheral pulmonary lesions
Author(s) -
Kato Akane,
Yasuo Masanori,
Tokoro Yayoi,
Kobayashi Takashi,
Ichiyama Takashi,
Tateishi Kazunari,
Ushiki Atsuhito,
Urushihata Kazuhisa,
Yamamoto Hiroshi,
Hanaoka Masayuki
Publication year - 2018
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.13377
Subject(s) - medicine , biopsy , radiology , peripheral , yield (engineering) , computed tomography , significant difference , materials science , metallurgy
Background and objective Virtual bronchoscopic navigation (VBN) entails the provision of a virtual display of the bronchial routes that lead to small peripheral pulmonary lesions (PPL). It has been predicted that a combination of computed tomography (CT)‐guided transbronchial biopsy (CT‐TBB) with VBN might improve the diagnostic yield for small PPL. This study sought to investigate that prediction. Methods A total of 100 patients with small PPL (<20 mm) were enrolled for CT‐TBB and randomly allocated to either a VBN+ or VBN− group (50 subjects per group). Group results were then compared in terms of diagnostic yield, whole procedure time, times at which the first CT scan and biopsy were taken and the number of lung biopsy specimens retrieved. Results The diagnostic yield for small PPL was significantly higher in the VBN+ group versus VBN− group (84% vs 58%, respectively ( P = 0.013)), with no significant difference in (whole) examination time between groups (VBN+: 32:53 (32 min and 53 s) ± 12:01 vs VBN−: 33:06 ± 10:08 ( P = NS)). However, the time periods between commencing the examination and either the first CT scan or first biopsy were significantly shorter for the VBN+ group, while the net biopsy time tended to be longer for this group with a significantly higher number of specimens collected (VBN+: 3.54 ± 1.07 specimens vs VBN−: 2.98 ± 1.06 specimens ( P = 0.01)). Conclusion Combining VBN with CT‐TBB significantly improved the diagnostic yield for small PPL.