Electromagnetic navigation bronchoscopy transbronchial lung nodule ablation with Illumisite TM platform corrects CT-to-body divergence with tomosynthesis and improves ablation workflow: a case report.

Autor:	Chan JWY; Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China., Chang ATC; Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China., Siu ICH; Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China., Lau RWH; Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China., Ng CSH; Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
Jazyk:	angličtina
Zdroj:	AME case reports [AME Case Rep] 2023 Feb 20; Vol. 7, pp. 13. Date of Electronic Publication: 2023 Feb 20 (Print Publication: 2023).
DOI:	10.21037/acr-22-49
Abstrakt:	Background: Transbronchial ablation of lung nodules is gaining popularity as part of lung-preserving strategy for patients with multifocal lung cancers or multiple lung oligometastases. Accuracy in placement of ablation catheter is of utmost importance in order to achieve adequate ablation margin. However, older systems are not precise enough for confident placement of ablation catheter and often require multiple cone-beam CT (CBCT) to confirm and readjust its position. The following case is the first microwave lung ablation utilizing the novel Illumisite TM platform (Medtronic, Minneapolis, MN, USA) in the hybrid operating room (HOR), with enhanced accuracy and workflow. Case Description: A 66-year-old lady had multiple resected adenocarcinomas in bilateral lungs. Upon CT monitoring a right middle lobe (RML) ground glass opacity with solid centre was found to be suspicious due to increasing size and density. Transbronchial electromagnetic navigation bronchoscopy (ENB) microwave ablation of the lesion was performed as part of lung-conserving strategy. After initial navigation, the adjusted nodule position provided by the IllumisiteTM platform after correcting the CT-to-body divergence prompted operators to renavigate and readjust the position of the locatable guide (LG) swiftly to gain accurate access to the nodule, which was confirmed by CBCT. Positional data at the tip of extended working channel (EWC) also allowed precise placement of needle for subsequent ablation. Conclusions: Illumisite TM is a novel electromagnetic navigational platform that corrects for CT-to-body divergence and ensures continuous locational information by an additional positional coil in the tip of EWC. This precision is especially important for the placement of ablation catheter, as slight deviation would lead to insufficient ablation margin and future recurrence. Workflow is improved by reducing the number of CBCT required for instrument position adjustment. 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-22-49/coif). The series “Case Reports in Hybrid Operating Theatre” was commissioned by the editorial office without any funding or sponsorship. JWYC served as the unpaid Guest Editor of the series. RWHL is a consultant for Medtronic, USA; Johnson & Johnson; and Siemens Healthineer. CSHN served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of AME Case Reports. CSHN is a consultant for Medtronic, USA; Johnson and Johnson; and Siemens Healthineer. All remaining authors declare no potential conflicts of interest that exist with any companies/organizations whose products or services are discussed in this article. The IllumisiteTM platform (Medtronic, Minneapolis, MN, USA) is not involved in the management of the case, and all authors declare no financial interest with the above device company. The authors have no other conflicts of interest to declare. (2023 AME Case Reports. All rights reserved.)
Databáze:	MEDLINE
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