Combination of virtual bronchoscopic navigation with conventional transbronchial needle aspiration in the diagnosis of peribronchial pulmonary lesions located in the middle third of the lungs
| Autor: | Takashi Kobayashi, Kazutoshi Hamanaka, Mineyuki Hama, Takashi Ichiyama, Masayuki Hanaoka, Hiroshi Yamamoto, Toshimichi Horiuchi, Takayuki Honda, Satoshi Kawakami, Masanori Yasuo |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Ebus tbna Novel technique medicine.medical_specialty Lung Neoplasms Bronchi Computed tomography 030204 cardiovascular system & hematology Unmet needs User-Computer Interface 03 medical and health sciences 0302 clinical medicine Bronchoscopy medicine Humans Fluoroscopy Central airway Endobronchial ultrasound Aged Aged 80 and over medicine.diagnostic_test business.industry Biopsy Needle Bronchial Neoplasms Middle Aged 030228 respiratory system Female Radiology business |
| Zdroj: | Respiratory Investigation. 54:355-363 |
| ISSN: | 2212-5345 |
| Popis: | Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is frequently applied to the diagnosis of central airway lesions, and endobronchial ultrasound with a guide sheath (EBUS-GS) is mainly used for the diagnosis of peripheral pulmonary lesions. However, there remains an unmet need to improve the diagnostic yields for peribronchial pulmonary lesions located along the secondary/tertiary and fourth/fifth bronchi (the "middle third zone" of the lungs), which neither EBUS-TBNA nor EBUS-GS can easily approach. Methods A combination of virtual bronchoscopic navigation (VBN) with conventional TBNA was utilized for the cytological diagnosis of 15 patients with small pulmonary lesions (less than 20mm in diameter) in the middle third zone between March 2012 and January 2015 in our respiratory institute. The lesions were traced using the VBN system, and then the VBN was operated and guided by the vision of actual bronchoscopy. The TBNA site was determined by VBN, and the specimens were obtained using conventional TBNA under X-ray fluoroscopy. The diagnosis was made based on the cytological findings of the specimens. Results Adequate specimens were obtained in 12 (80.0%) of the cases through the novel technique of combining TBNA with VBN in bronchoscopic examinations. Seven out of the ten malignant cases (70.0%) were definitely diagnosed by this procedure. No adverse effects were experienced, except for an acceptable amount of bleeding. Conclusions The combination of VBN with conventional TBNA was advantageous and safe for the cytological diagnosis of small peribronchial pulmonary lesions in the middle third zone of the lungs. |
| Databáze: | OpenAIRE |
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