SESSION TITLE: EBUS and Advanced Bronchoscopy Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM
PURPOSE: New endobronchial navigational device has been tested. We compared confirmatory value of near infrared (NIR) spectroscopy navigational catheter with endobronchial ultrasound in diagnostic algorithm of SPN. Fluoroscopic guidance was executed in all patients. TBB with histology and needle biopsy with cytology evaluation were also done in all patients.
METHODS: In our study we used 2 point monitoring confirmatory systems. Fluoroscopic guidance has been combined with either radial EBUS probe or NIR spectroscopy probe tissue confirmation. NIR spectroscopic probe has been designed containing flexible forceps to achieve real- time biopsy during navigation procedure. Instrument functionality is based on measurement of penetrated NIR radiation through lung tissue. Both indicating and source fibres in one bundle are navigated towards the SPN Patient population consisted of 210 patients with CT/PET finding of metabolically active solitary pulmonary node 1.2-3 cm in diameter examined from 11/2011 to 4/2013. There were 139 male and 71 female patients with medial age 68 years. 82% of them were smokers with homogenous distribution in both groups. EBUS radial probe was used as described elsewhere during fluoroscopy navigation.
RESULTS: From 106 patients in the fluoroscopy + EBUS group there were 82 histologies/cytologies confirming the diagnosis with the hit rate of the procedure in our cohort 77%. NIR spectroscopy + fluoroscopy use led to hit rate 87% with 90 of positive histologies/cytologies in 104 patients.
CONCLUSIONS: NIR spectroscopy catheter navigation with real - time biopsy technique has got insignificantly better efficacy as radial EBUS in confirmation of ideal biopsy place in our group of patients. The amount of positive biopsies were however more dependent on the ability of bronchologist to direct confirmatory device to SPN during fluoroscopy guidance than on the type of confirmatory device. The advantage of NIR- navigation is in real- time biopsy possibility and much lower cost of the technique.
CLINICAL IMPLICATIONS: Recently SPNs are more often encountered because of the widespread use of CT for the diagnostic and screening purposes. We introduce new navigational technic with good comparative value against EBUS navigation. Such device could be easily included for example into the examination by electromagnetic navigation.
DISCLOSURE: The following authors have nothing to disclose: Jiri Votruba, Tomas Bruha
Technique has been approved by local ethic commitee and is completely non-invasive.