The Impact of Biopsy Tool Choice and Rapid On-Site Evaluation on Diagnostic Accuracy for Malignant Lesions in the Prospective: Multicenter NAVIGATE Study
| Autor: | Jennifer S. Mattingley, Gregory P. LeMense, Thomas R. Gildea, Douglas A. Arenberg, Philip A. Linden, Jaspal Singh, Navigate Study Investigators, Erik Folch, Atul C. Mehta, Joseph Cicenia, Amit K. Mahajan, Otis B. Rickman, Sandeep J. Khandhar, Michael A. Pritchett, Haiying Lin |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung Neoplasms bronchoscopy lung neoplasms/diagnosis Biopsy Forceps fine-needle Original Investigations aspiration biopsy Site evaluation Malignancy medicine Humans Prospective Studies Lung cancer medicine.diagnostic_test business.industry Pneumothorax medicine.disease Bronchoalveolar lavage image-guided biopsy Radiology business Electromagnetic Phenomena Electromagnetic navigation bronchoscopy |
| Zdroj: | Journal of Bronchology & Interventional Pulmonology |
| ISSN: | 1948-8270 |
| Popis: | Background The diagnostic yield of electromagnetic navigation bronchoscopy (ENB) is impacted by biopsy tool strategy and rapid on-site evaluation (ROSE) use. This analysis evaluates usage patterns, accuracy, and safety of tool strategy and ROSE in a multicenter study. Methods NAVIGATE (NCT02410837) evaluates ENB using the superDimension navigation system (versions 6.3 to 7.1). The 1-year analysis included 1215 prospectively enrolled subjects at 29 United States sites. Included herein are 416 subjects who underwent ENB-aided biopsy of a single lung lesion positive for malignancy at 1 year. Use of a restricted number of tools (only biopsy forceps, standard cytology brush, and/or bronchoalveolar lavage) was compared with an extensive multimodal strategy (biopsy forceps, cytology brush, aspirating needle, triple needle cytology brush, needle-tipped cytology brush, core biopsy system, and bronchoalveolar lavage). Results Of malignant cases, 86.8% (361/416) of true positive diagnoses were obtained using extensive multimodal strategies. ROSE was used in 300/416 cases. The finding of malignancy by ROSE reduced the total number of tools used. A malignant ROSE call was obtained in 71% (212/300), most (88.7%; 188/212) by the first tool used (49.5% with aspirating needle, 20.2% with cytology brush, 17.0% with forceps). True positive rates were highest for the biopsy forceps (86.9%) and aspirating needle (86.6%). Use of extensive tool strategies did not increase the rates of pneumothorax (5.5% restricted, 2.8% extensive) or bronchopulmonary hemorrhage (3.6% restricted, 1.1% extensive). Conclusion These results suggest that extensive biopsy tool strategies, including the aspirating needle, may provide higher true positive rates for detecting lung cancer without increasing complications. |
| Databáze: | OpenAIRE |
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