PURPOSE: Lung Point Virtual Bronchoscopic Navigation System (LPVBN) is a sophisticated planning and assessment module, with side-by-side visual synchronization of the real-time and virtual airway navigation to the desired target lesion. We evaluated the feasibility, diagnostic yield, and complications of the procedure for diagnosis of pulmonary lesions (including peripheral pulmonary lesions and lesions < 2cm in diameter), mediastinal, and hilar lymphadenopathy.
METHODS: Prospective data collection of the patients undergoing LPVBN guided tissue biopsies of lung and/or mediastinal lesions.
RESULTS: To date, 13 patients have undergone LPVBN over a 4 month period. Twelve transbronchial biopsies of lung nodules were completed, 7 were pulmonary lesions > 2cm in diameter, and 4 were < 2 cm in diameter with diagnostic yields of 71% and 50% respectively. 7 lesions were within the middle 1/3, and 4 within the outer 1/3 with diagnostic yields of 71% and 50% respectively. One transbronchial biopsy of diffuse lung disease was performed using a cryoprobe with diagnostic results. The number of FNA was 11, consisting of 7 hilar and 4 subcarinal lymph nodes with diagnostic yields of 57% and 100% respectively. Fluoroscopic guidance was used in association with LPVBN in 3 of 11 transbronchial biopsies. No complications were observed.
CONCLUSION: LPVBN enables more accurate planning and guidance of bronchoscopy, potentially exceeding standard bronchoscopy in the sampling of different pulmonary lesions, mediastinal and hilar lymphadenopathy, regardless of size or location of the target.
CLINICAL IMPLICATIONS: LPVBN promises to be a valuable and user friendly diagnostic bronchoscopy tool. Complication rate and referral for surgical biopsies are expected to be low with the use of this new modality (data to follow). Diagnostic yields adjusted for different lesions can potentially be used for comparative analysis of novel technologies as well as quality improvement initiatives.
DISCLOSURE: Heba Ismail, No Financial Disclosure Information; No Product/Research Disclosure Information