Electromagnetic navigation diagnostic bronchoscopy - A prospective study
Electromagnetic navigation diagnostic bronchoscopy - A prospective study
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DOI：
10.1164/rccm.200603-344oc
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发表时间：
2006-11-01
影响因子：
24.7
通讯作者：
Mehta, Atul C.
中科院分区：
文献类型：
--
作者：
Gildea, Thomas R.;Mazzone, Peter J.;Mehta, Atul C.
目的：通过一项前瞻性、开放式、单中心、先导性研究，探讨电磁导航支气管镜在标准支气管镜仪器上采集周围肺病变和纵隔淋巴结的能力，并证明其安全性。方法：电磁导航支气管镜系统由电磁板、可定向探头尖端的位置传感器、扩展的工作通道和实时重建先前获得的多平面计算机断层扫描图像组成。收集可定向探头到病变的最终距离、基于实际标记和虚拟标记的预期误差以及操作成品率。测量：于2004年12月至2005年9月纳入60名受试者。周围型病变平均导航时间为7+/-6min，淋巴结平均导航时间为22min。在所有病例中，可定向的探头尖端都被导航到靶肺区域。周围病变和淋巴结平均大小分别为22.8±12.6 mm和28.1±12.8 mm。结果：周围性病变和淋巴结的良好率分别为74%和100%。80.3%的支气管镜检查获得了诊断。74.4%的受试者明确诊断为肺部恶性肿瘤。结论：电磁导航支气管镜是一种安全的对周围和纵隔病变进行采样的方法，具有独立于病变大小和位置的高诊断率。
Rationale: Electromagnetic navigation bronchoscopy using super Dimension/Bronchus System is a novel method to increase diagnostic yield of peripheral and mediastinal lung lesions.Objectives: A prospective, open label, single-center, pilot study was conducted to determine the ability of electromagnetic navigation bronchoscopy to sample peripheral lung lesions and mediastinal lymph nodes with standard bronchoscopic instruments and demonstrate safety.Methods: Electromagnetic navigation bronchoscopy was performed using the superDimension/Bronchus system consisting of electromagnetic board, position sensor encapsulated in the tip of a steerable probe, extended working channel, and real-time reconstruction of previously acquired multiplanar computed tomography images. The final distance of the steerable probe to lesion, expected error based on the actual and virtual markers, and procedure yield was gathered.Measurements: 60 subjects were enrolled between December 2004 and September 2005. Mean navigation times were 7 +/- 6 min and 2 2 min for peripheral lesions and lymph nodes, respectively. The steerable probe tip was navigated to the target lung area in all cases. The mean peripheral lesions and lymph nodes size was 22.8 +/- 12.6 mm and 28.1 +/- 12.8 mm. Yield was determined by results obtained during the bronchoscopy per patient.Results: The yield/procedure was 74% and 100% for peripheral lesions and lymph nodes, respectively. A diagnosis was obtained in 80.3% of bronchoscopic procedures. A definitive diagnosis of lung malignancy was made in 74.4% of subjects. Pneumothorax occurred in two subjects.Conclusion: Electromagnetic navigation bronchoscopy is a safe method for sampling peripheral and mediastinal lesions with high diagnostic yield independent of lesion size and location.