PURPOSE: The main problem in early diagnosis of lung cancer remains the ability to reach small lung lesions and obtain diagnostic tissue samples. Electromagnetic navigation guided bronchoscopy (ENB) has been approved for use as an assisting tool for diagnosing peripheral lung lesions via bronchoscopes. This prospective study was aimed to assess the diagnostic yield of the Super Dimension Bronchus System™ (SD) in pulmonary nodules less than 3 cm and compare the difference in tissue sampling techniques.
METHODS: 54 patients (14 women, 40 men) underwent SD-guided bronchoscopy during which one peripheral lung lesion was navigated to and biopsied twice. Primary end-point was the diagnostic yield of ENB without additional use of fluoroscopy. Other parameters, such as tissue sampling modality, procedure time, distance to targeted lesion, as well as lesion parameters such as size and location, were also collected. Patients were followed up until the definitive diagnosis was obtained and / or the diagnosis was verified by another technique.
RESULTS: 39 of 54 patients (72.2 %) were diagnosed correctly (definitive histology or benign results that were confirmed with follow-up) with the SD technique. The mean lesion size was 23.3 mm ranging from 14 mm to 29 mm. Mean navigation duration was 3.5 minutes (ranging from 0.3 to 14 minutes). Sampling method of catheter suction was more successful than the forceps biopsy (p=0.035). One pneumothorax occurred (1.92 %), which was small and no intervention was necessary.
CONCLUSION: ENB is a safe diagnostic approach that increases significantly the diagnostic yield of peripheral lung lesion biopsies compared with standard bronchoscopy. Sampling by catheter suction appears superior to forceps biopsy.
CLINICAL IMPLICATIONS: ENB can be used to obtain histological diagnosis in peripheral lung lesions.
DISCLOSURE: Ralf Eberhardt, No Product/Research Disclosure Information; Consultant fee, speaker bureau, advisory committee, etc. Armin Ernst was previously a member of the scientific advisory board of Superdimension/Bronchus. He was given stock options which have been returned.