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Original Research: INTERVENTIONAL PULMONOLOGY |

Real-Time Electromagnetic Navigation Bronchoscopy to Peripheral Lung Lesions Using Overlaid CT Images : The First Human Study

Yehuda Schwarz, MD; Joel Greif, MD; Heinrich D. Becker, MD; Armin Ernst, MD; Atul Mehta, MD
Author and Funding Information

*From the Tel-Aviv Sourasky Medical Center (Drs. Schwarz and Greif), Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; Thoraxklinik at University of Heidelberg (Dr. Becker), Heidelberg, Germany; Beth-Israel Deaconess Medical Center (Dr. Ernst), Boston, MA; and The Cleveland Clinic Foundation (Dr. Mehta), Cleveland, OH.

Correspondence to: Yehuda Schwarz, MD, Pulmonary Institute, Tel Aviv Sourasky Medical Center, Weizman Stt 6, Tel Aviv 64239, Israel; e-mail: Schwarz@tasmc.health.gov.il



Chest. 2006;129(4):988-994. doi:10.1378/chest.129.4.988
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Study objectives: To characterize the feasibility, accuracy, and safety of the superDimension/Bronchus system (SDBS) [superDimension, Ltd; Hertzliya, Israel] in navigating to previously unreachable peripheral lung lesions and obtaining biopsy specimens.

Design: Open-label, prospective, controlled clinical study.

Setting: Pulmonary institute of a university-affiliated municipal hospital.

Patients: Thirteen adult candidates for nonemergency bronchoscopy who gave informed consent to participate.

Interventions: The patients underwent flexible bronchoscopy using the SDBS, which is based on real-time CT-guided electromagnetic navigation and is capable of reaching peripheral lung masses beyond the reach of the bronchoscope. A position sensor was used to navigate to and sample the various target lesions for biopsy.

Measurements and results: Three-dimensional chest CT was followed by SDBS methodology for marking anatomic landmarks and the target lesion on a virtual bronchoscopy screen and for sampling the lesion. The SDBS assisted in obtaining positive biopsy diagnoses in 9 of 13 cases (69%), with an average navigation accuracy of 5.7 mm. There were no SDBS-related adverse events.

Conclusions: The SDBS is safe and effective in navigating to peripheral lung lesions located beyond the optic limits of a standard flexible bronchoscope.

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