Cargando…

Pilot study using virtual 4-D tracking electromagnetic navigation bronchoscopy in the diagnosis of pulmonary nodules: a single center prospective study

BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) is a navigation technology intended to improve the diagnostic yield of pulmonary nodules. However, nodule displacement due to respiratory motion may compromise the accuracy of the navigation guidance. The Veran SPiNDrive ENB system employs re...

Descripción completa

Detalles Bibliográficos
Autores principales: Ishiwata, Tsukasa, Ujiie, Hideki, Gregor, Alexander, Inage, Terunaga, Motooka, Yamato, Kinoshita, Tomonari, Aragaki, Masato, Chen, Zhenchian, Effat, Andrew, Bernards, Nicholas, Yasufuku, Kazuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182521/
https://www.ncbi.nlm.nih.gov/pubmed/34164180
http://dx.doi.org/10.21037/jtd-21-141
_version_ 1783704223713591296
author Ishiwata, Tsukasa
Ujiie, Hideki
Gregor, Alexander
Inage, Terunaga
Motooka, Yamato
Kinoshita, Tomonari
Aragaki, Masato
Chen, Zhenchian
Effat, Andrew
Bernards, Nicholas
Yasufuku, Kazuhiro
author_facet Ishiwata, Tsukasa
Ujiie, Hideki
Gregor, Alexander
Inage, Terunaga
Motooka, Yamato
Kinoshita, Tomonari
Aragaki, Masato
Chen, Zhenchian
Effat, Andrew
Bernards, Nicholas
Yasufuku, Kazuhiro
author_sort Ishiwata, Tsukasa
collection PubMed
description BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) is a navigation technology intended to improve the diagnostic yield of pulmonary nodules. However, nodule displacement due to respiratory motion may compromise the accuracy of the navigation guidance. The Veran SPiNDrive ENB system employs respiratory-gating (4D-tracking) to compensate for this motion. The aim of the present study was to evaluate the diagnostic performance and safety of the Veran SPiNDrive system for biopsy of pulmonary nodules. METHODS: Adult patients with pulmonary nodules of ≥1 cm were enrolled at a single center. Both conventional bronchoscopy and 4D-tracking ENB were performed in one procedure session under general anesthesia, with the procedure order being randomly assigned. Radial probe endobronchial ultrasound and fluoroscopy were used in both groups. The diagnostic performance, safety, total procedure time, and total fluoroscopy time of the ENB phase were compared to the corresponding conventional bronchoscopy phase. RESULTS: The study was terminated due to poor accrual; a total of eleven patients were enrolled. The mean size of pulmonary nodules was 2.1 cm. The sensitivity for malignancy was 67% (6/9) and 56% (5/9) with conventional bronchoscopy and with 4D-tracking ENB, respectively. Two cases developed minor bleeding after conventional bronchoscopy, while no complications were observed after 4D-tracking ENB. The mean procedure time was 16.1 and 21.7 min (P=0.090), and the mean duration time for fluoroscopy use was 77 and 44 sec (P=0.056) for the conventional bronchoscopy and the 4D-tracking ENB phases, respectively. CONCLUSIONS: The diagnostic performance of the Veran SPiNDrive 4D-tracking ENB did not exceed that of conventional bronchoscopy for pulmonary nodules. No complications were seen during 4D-tracking ENB. A study with a larger number of participants is required for further assessment.
format Online
Article
Text
id pubmed-8182521
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher AME Publishing Company
record_format MEDLINE/PubMed
spelling pubmed-81825212021-06-22 Pilot study using virtual 4-D tracking electromagnetic navigation bronchoscopy in the diagnosis of pulmonary nodules: a single center prospective study Ishiwata, Tsukasa Ujiie, Hideki Gregor, Alexander Inage, Terunaga Motooka, Yamato Kinoshita, Tomonari Aragaki, Masato Chen, Zhenchian Effat, Andrew Bernards, Nicholas Yasufuku, Kazuhiro J Thorac Dis Original Article BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) is a navigation technology intended to improve the diagnostic yield of pulmonary nodules. However, nodule displacement due to respiratory motion may compromise the accuracy of the navigation guidance. The Veran SPiNDrive ENB system employs respiratory-gating (4D-tracking) to compensate for this motion. The aim of the present study was to evaluate the diagnostic performance and safety of the Veran SPiNDrive system for biopsy of pulmonary nodules. METHODS: Adult patients with pulmonary nodules of ≥1 cm were enrolled at a single center. Both conventional bronchoscopy and 4D-tracking ENB were performed in one procedure session under general anesthesia, with the procedure order being randomly assigned. Radial probe endobronchial ultrasound and fluoroscopy were used in both groups. The diagnostic performance, safety, total procedure time, and total fluoroscopy time of the ENB phase were compared to the corresponding conventional bronchoscopy phase. RESULTS: The study was terminated due to poor accrual; a total of eleven patients were enrolled. The mean size of pulmonary nodules was 2.1 cm. The sensitivity for malignancy was 67% (6/9) and 56% (5/9) with conventional bronchoscopy and with 4D-tracking ENB, respectively. Two cases developed minor bleeding after conventional bronchoscopy, while no complications were observed after 4D-tracking ENB. The mean procedure time was 16.1 and 21.7 min (P=0.090), and the mean duration time for fluoroscopy use was 77 and 44 sec (P=0.056) for the conventional bronchoscopy and the 4D-tracking ENB phases, respectively. CONCLUSIONS: The diagnostic performance of the Veran SPiNDrive 4D-tracking ENB did not exceed that of conventional bronchoscopy for pulmonary nodules. No complications were seen during 4D-tracking ENB. A study with a larger number of participants is required for further assessment. AME Publishing Company 2021-05 /pmc/articles/PMC8182521/ /pubmed/34164180 http://dx.doi.org/10.21037/jtd-21-141 Text en 2021 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Ishiwata, Tsukasa
Ujiie, Hideki
Gregor, Alexander
Inage, Terunaga
Motooka, Yamato
Kinoshita, Tomonari
Aragaki, Masato
Chen, Zhenchian
Effat, Andrew
Bernards, Nicholas
Yasufuku, Kazuhiro
Pilot study using virtual 4-D tracking electromagnetic navigation bronchoscopy in the diagnosis of pulmonary nodules: a single center prospective study
title Pilot study using virtual 4-D tracking electromagnetic navigation bronchoscopy in the diagnosis of pulmonary nodules: a single center prospective study
title_full Pilot study using virtual 4-D tracking electromagnetic navigation bronchoscopy in the diagnosis of pulmonary nodules: a single center prospective study
title_fullStr Pilot study using virtual 4-D tracking electromagnetic navigation bronchoscopy in the diagnosis of pulmonary nodules: a single center prospective study
title_full_unstemmed Pilot study using virtual 4-D tracking electromagnetic navigation bronchoscopy in the diagnosis of pulmonary nodules: a single center prospective study
title_short Pilot study using virtual 4-D tracking electromagnetic navigation bronchoscopy in the diagnosis of pulmonary nodules: a single center prospective study
title_sort pilot study using virtual 4-d tracking electromagnetic navigation bronchoscopy in the diagnosis of pulmonary nodules: a single center prospective study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182521/
https://www.ncbi.nlm.nih.gov/pubmed/34164180
http://dx.doi.org/10.21037/jtd-21-141
work_keys_str_mv AT ishiwatatsukasa pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy
AT ujiiehideki pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy
AT gregoralexander pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy
AT inageterunaga pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy
AT motookayamato pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy
AT kinoshitatomonari pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy
AT aragakimasato pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy
AT chenzhenchian pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy
AT effatandrew pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy
AT bernardsnicholas pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy
AT yasufukukazuhiro pilotstudyusingvirtual4dtrackingelectromagneticnavigationbronchoscopyinthediagnosisofpulmonarynodulesasinglecenterprospectivestudy