Combined portable cone beam computed tomography and robotic-assisted bronchoscopy impacting diagnosis of a solitary pulmonary nodule: a case report.

Autor:	Duke JD; Division of Pulmonary Medicine, Mayo Clinic, Rochester, MN, USA., Fernandez-Bussy S; Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, FL, USA., Reisenauer J; Division of Pulmonary Medicine, Mayo Clinic, Rochester, MN, USA.; Division of Thoracic Surgery, Mayo Clinic, Rochester, MN, USA.
Jazyk:	angličtina
Zdroj:	AME case reports [AME Case Rep] 2022 Jul 25; Vol. 6, pp. 23. Date of Electronic Publication: 2022 Jul 25 (Print Publication: 2022).
DOI:	10.21037/acr-22-5
Abstrakt:	Background: Lung cancer is the leading cause of cancer-related mortality in men and women throughout the world. Historically, bronchoscopy played a limited role in pulmonary nodule management due to a limited diagnostic accuracy. With the emergence of robotic bronchoscopy, proceduralists can now navigate to more peripheral lesions completely extrinsic to the airways with increased diagnostic yield. Despite the increased diagnostic yield from robotic-assisted bronchoscopy, challenges in exact localization of the lesion during a procedure can occur. This case highlights a novel use of robotic bronchoscopy combined with mobile three-dimensional (3D) imaging to optimize lesion location for biopsy previously not reported in the literature. Case Description: We describe a case where the combination of robotic bronchoscopy with new mobile 3D imaging was essential for the accurate biopsy of an incidentally found pulmonary nodule in a 72-year-old woman. Initial navigation to the nodule using robotic bronchoscopy resulted in the catheter being inferior to the area of interest. After renavigation using the information provided by mobile 3D imaging, we were able to confirmed tool-in-lesion prior to biopsy. The patient was diagnosed with adenocarcinoma with papillary features and underwent a lobectomy with a favorable prognosis. Conclusions: A diagnosis of adenocarcinoma was made for this patient utilizing the novel combined technique of robotic peripheral pulmonary nodule biopsy with portable 3D imaging, which may improve overall diagnostic accuracy of bronchoscopic biopsy. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://acr.amegroups.com/article/view/10.21037/acr-22-5/coif). JR has an independent research grant with intuitive surgical that is outside the scope of this work, and receives equipment loan for a clinical study from Siemens. The other authors have no conflicts of interest to declare. (2022 AME Case Reports. All rights reserved.)
Databáze:	MEDLINE
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