Cone-Beam CT With Augmented Fluoroscopy Combined With Electromagnetic Navigation Bronchoscopy for Biopsy of Pulmonary Nodules

Autor: Stephanie Schampaert, Joris A. H. de Groot, Imramsjah M. J. van der Bom, Michael A. Pritchett, Charles Schirmer
Rok vydání: 2018
Předmět:
Male
Pulmonary and Respiratory Medicine
Lung Neoplasms
Biopsy
medicine.medical_treatment
Original Investigations
Lesion
03 medical and health sciences
0302 clinical medicine
electromagnetic navigation bronchoscopy
Neoplasms
Bronchoscopy
Prevalence
medicine
Humans
Fluoroscopy
030212 general & internal medicine
Lung
Cone beam ct
Aged
Neoplasm Staging
Retrospective Studies
Mechanical ventilation
medicine.diagnostic_test
business.industry
augmented fluoroscopy
Pneumothorax
Cone-Beam Computed Tomography
medicine.disease
Cbct imaging
lung cancer
030228 respiratory system
cone-beam CT
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Feasibility Studies
Multiple Pulmonary Nodules
Female
medicine.symptom
Nuclear medicine
business
Electromagnetic Phenomena
Software
Electromagnetic navigation bronchoscopy
Zdroj: Journal of Bronchology & Interventional Pulmonology
ISSN: 1944-6586
Popis: Supplemental Digital Content is available in the text.
Background: Electromagnetic navigation bronchoscopy (ENB) has been widely adopted as a guidance technique for biopsy of peripheral lung nodules. However, ENB is limited by the lack of real-time confirmation of the biopsy devices. Intraprocedural cone-beam computed tomography (CBCT) imaging can be utilized to assess or confirm the location of biopsy devices. The aim of this study is to determine the safety and diagnostic yield (DY) of image fusion of intraprocedural CBCT data with live fluoroscopy (augmented fluoroscopy) during ENB-guided biopsy of peripheral lung nodules. Methods: Data from 75 consecutive patients who underwent biopsy with ENB was collected retrospectively. Patients underwent CBCT imaging while temporarily suspending mechanical ventilation. CBCT data were acquired and 3-dimensional segmentation of nodules was performed using commercially available software (OncoSuite). During ENB, the segmented lesions were projected and fused with live fluoroscopy enabling real-time 3-dimensional guidance. Results: A total of 93 lesions with a median size of 16.0 mm were biopsied in 75 consecutive patients. The overall DY by lesion was 83.7% (95% confidence interval, 74.8%-89.9%). Multivariate regression analysis showed no independent correlation between lesion size, lesion location, lesion visibility under standard fluoroscopy, and the presence of a bronchus sign with DY. Pneumothorax occurred in 3 patients (4%). Conclusion: Intraprocedural CBCT imaging with augmented fluoroscopy is feasible and effective and is associated with high DY during ENB-guided biopsies.
Databáze: OpenAIRE
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