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Electromagnetic Navigation Diagnostic Bronchoscopy (ENB)

Year 2018, , 237 - 243, 30.09.2018
https://doi.org/10.18663/tjcl.356585

Abstract

Advances in computer technology have permitted
development of virtual reality images of the tracheobronchial tree using data
sets derived from helical CT of the chest.
Peripheral pulmonary lesions (PPL) are common incidental findings. Their
rising incidence has paralleled the increasing use of computed tomography (CT)
as CT is approximately three times more sensitive than plain chest radiography
(CXR) scans. Electromagnetic navigation bronchoscopy (ENB) is an exciting new
bronchoscopic technique that promises accurate navigation to peripheral
pulmonary target lesions.
CT-guided transthoracic needle aspiration (TTNA)
is a common method of obtaining tissue and whilst its pooled sensitivity for
malignancy of %90 is impressive it also has a false negative rate of %20-30. Furthermore
it is complicated by minor pneumothorax in approximately %25 of cases and major
pneumothorax requiring a chest tube in %5 of cases. The main advantage of using
bronchoscopic techniques rather than transthoracic biopsy is its superior
safety profile.
Electromagnetic
navigation-guided bronchoscopy has the potential to improve the diagnostic
yield of transbronchial biopsies without additional fluoroscopic guidance, and
may be useful in the early diagnosis of lung cancer, particularly in
nonoperable patients.

References

  • 1. Spiro SG, Porter JC. Lung cancer-Where are we today? Current advances in staging and nonsurgical treatment. Am J Respir Crit Care Med 2002; 166: 1166-96.
  • 2. Parkin GM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin 1999; 49: 33- 64.
  • 3. Kanser bildirimlerinin değerlendirilmesi 1993-1994. T.C. Sağlık Bakanlığı Kanser Savaş Daire başkanlığı. Yayın no:582, Ankara 1997.
  • 4. Bray F, Pisani P, Parkin DM. GLOBOCAN 2002. Cancer Incidence, Mortality and Prevalance Worldwide, Descriptive Epidemiology Group. IARC CancerBase No. 5, version 2.0, IARCPress, Lyon, 2004.
  • 5. Smith RA, Glynn TJ. Epidemiology of lung cancer. Radiol Clin North Am 2000; 38: 453- 70.
  • 6. Sone S, Takashima S, Li F et al. Mass screening for lung cancer with mobile spiral computed tomography scanner. Lancet 1998; 351: 1242–45.
  • 7. Henschke CI, McCauley DI, Yankelevitz DF et al. Early lung cancer action project: a summary of the findings on baseline screening. Oncologist 2001; 6: 147–52.
  • 8. Geraghty PR, Kee ST, McFarlane G, Razavi MK, Sze DY, Dake MD. CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. Radiology 2003; 229: 475–81.
  • 9. Kato R, Katada K, Anno H, Suzuki S, Ida Y, Koga S. Radiation dosimetry at CT fluoroscopy: physician’s hand dose and development of needle holders. Radiology 1996;201: 576–78.
  • 10. Baaklini W, Reinoso M, Gorin A, Sharafkaneh A, Manian P. Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest 2000; 117: 1049–54.
  • 11. Cortese DA, McDougall JC. Biopsy and brushing of peripheral lung cancer with fluoroscopic guidance. Chest 1979; 75: 141–45.
  • 12. Laurent F, Michel P, Latrabe V, Tunon de Lara M, Marthan R. Pneumothoraces and chest tube placement after CT-guided transthoracic lung biopsy using a coaxial technique: incidence and risk factors. AJR Am J Roentgenol 1999; 172: 1049–53.
  • 13. Merritt SA, Gibbs JD , Yu KC , Patel V , Rai L, Cornish DC, Bascom R, Higgins WE. Image-Guided Bronchoscopy for Peripheral Lung Lesions* A Phantom Study. CHEST 2008; 134:1017–1026.
  • 14. Eberhardt R, Kahn N, Gompelmann D, Schumann M, Heussel CP, Herth FJ. LungPoint-a new approach to peripheral lesions. J. Thorac. Oncol. 2010; 5: 1559–63.
  • 15. Ross JB, Phoneix AZ. ATS 2010 IC, Session A44, poster G59.
  • 16. Herth FJF, Gompelmann D, Kahn N, Eberhardt R. ATS 2010 IC. Session A44, poster G54.
  • 17. Leong S, Ju H, Marshall H, Bowman R, Yang I, Ree AM, Saxon C, Fong KM. Electromagnetic navigation bronchoscopy: A descriptive analysis. J Thorac Dis 2012; 4: 173-85.
  • 18. Makris D, Scherpereel A, Leroy S et al. Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions. Eur Respir J 2007; 29: 1187-92.
  • 19. Seijo LM, de Torres JP, Lozano MD et al. Diagnostic yield of electromagnetic navigation bronchoscopy is highly dependent on the presence of a Bronchus sign on CT imaging: results from a prospective study. Chest 2010; 138: 1316-21.
  • 20. Wilson DS, Bartlett RJ. Improved Diagnostic Yield of Bronchoscopy in a Community Practice: Combination of Electromagnetic Navigation System and Rapid On-site Evaluation. J Bronchol 2007; 14: 227-32.
  • 21. Becker HD, Harms W, Debus J, Bruekner D, McLemore T. Brachytherapy of inoperable peripheral lung cancer guided by electromagnetic navigation and endobronchial ultrasound: Feasibility study and confirmation by longterm results at two centers. Chest Meeting Abstracts 2009; 136: 2.
  • 22. Hautmann H, Schneider A, Pinkau T, Peltz F, Feussner H. Electromagnetic catheter navigation during bronchoscopy: validation of a novel method by conventional fluoroscopy. Chest 2005; 128: 382-7.
  • 23. Gildea TR, Mazzone PJ, Karnak D, Meziane M, Mehta AC. Electromagnetic navigation diagnostic bronchoscopy: a prospective study. Am J Respir Crit Care Med 2006; 174: 982-89.
  • 24. Schwarz Y, Mehta AC, Ernst A et al. Electromagnetic navigation during flexible bronchoscopy. Respiration 2003; 70: 516-22.
  • 25. Lamprecht B, Porsch P, Pirich C, Studnicka M. Electromagnetic navigation bronchoscopy in combination with PET-CT and rapid on-site cytopathologic examination for diagnosis of peripheral lung lesions. Lung 2009; 187: 55-59.
  • 26. Bertoletti L, Robert A, Cottier M, Chambonniere ML, Vergnon JM. Accuracy and feasibility of electromagnetic navigated bronchoscopy under nitrous oxide sedation for pulmonary peripheral opacities: an outpatient study. Respiration 2009; 78: 293-300.
  • 27. Eberhardt R, Anantham D, Ernst A, Feller-Kopman D, Herth F. Multimodality bronchoscopic diagnosis of peripheral lung lesions: a randomized controlled trial. Am J Respir Crit Care Med 2007; 176: 36-41.
  • 28. Paone G, Nicastri E, Lucantoni G et al. Endobronchial ultrasound-driven biopsy in the diagnosis of peripheral lung lesions. Chest 2005; 128: 3551-57.
  • 29. Naidich DP, Sussman R, Kutcher WL, Aranda CP, Garay SM, Ettenger NA. Solitary pulmonary nodules. CT-bronchoscopic correlation. Chest 1988; 93: 595-98.
  • 30. Becker HD, Herth F, Ernst A, Schwarz Y. Bronchoscopic Biopsy of Peripheral Lung Lesions Under Electromagnetic Guidance: A Pilot Study. J Bronchology 2005; 12: 9-13.
  • 31. Eberhardt R, Anantham D, Herth F, Feller-Kopman D, Ernst A. Electromagnetic navigation diagnostic bronchoscopy in peripheral lung lesions. Chest 2007; 131: 1800-5.
  • 32. Schwar z Y, Greif J, Becker HD, Ernst A, Mehta A. Real-time electromagnetic navigation bronchoscopy to peripheral lung lesions using overlaid CT images: the first human study. Chest 2006; 129: 988-94.
  • 33. Naidich DP, Sussman R, Kutcher WL, Aranda CP, Garay SM, Ettenger NA. Solitary pulmonary nodules. CT-bronchoscopic correlation. Chest 1988; 93: 595-98.
  • 34. Seijo LM, de Torres JP, Lozano MD et al. Diagnostic yield of electromagnetic navigation bronchoscopy is highly dependent on the presence of a Bronchus sign on CT imaging: results from a prospective study. Chest 2010; 138: 1316-21.
  • 35. Steinfort DP, Khor YH, Manser RL, Irving LB. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis. Eur Respir J 2011; 37: 902-10.
  • 36. Schroeder C, Hejal R, Linden PA. Coil spring fiducial markers placed safely using navigation bronchoscopy in inoperable patients allows accurate delivery of CyberKnife stereotactic radiosurgery. J Thorac Cardiovasc Surg 2010; 140: 1137-42.

Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB)

Year 2018, , 237 - 243, 30.09.2018
https://doi.org/10.18663/tjcl.356585

Abstract

Bilgisayar teknolojisindeki ilerlemeler, spiral toraks bilgisayarlı (BT)
tomografisinden elde edilen verilerin kullanılarak, trakeobronşiyal ağacın
sanal gerçeklikteki görüntülerinin oluşturulmasına imkan tanımaktadır. Periferik
pulmoner lezyonlar yapılan görüntüleme tekniklerinde raslantısal olarak yaygın
şekilde görülmektedir.  Bu lezyonların
giderek artan sıklıkta görülmesi, direk grafilerden üç kat daha duyarlı olan BT
kullanımını artırmaktadır. Yeni bir bronkoskopik teknik olan
elektromanyetik navigasyon diyagnostik
bronkoskopi (ENB), periferal pulmoner lezyonlarda doğru tanı oranını artırmada
gelecek vadeden bir yöntem olmaya başlamıştır. Bu lezyonların tanısında yaygın
olarak kullanılan BT eşliğinde yapılan ince iğne aspirasyon biyopsisi (TTİAB),
malign lezyonlarda %90 sensitiviteye sahipken %20 ila 30 oranında yanlış negatiflik
oranına sahiptir. Ayrıca bu yöntem yaklaşık %25 oranında minör pnömotoraksa yol
açmaktayken, %5 oranında göğüs tüpü drenajına gerek duyulmaktadır. Bronkoskopik
tekniklerin, transtorasik biyopsiye göre ana avantajı daha üstün bir güvenliğe
sahip olmasıdır. Elektromanyetik navigasyon diyagnostik bronkoskopi (ENB), ek
floroskopik yöntem kullanmadan, özellikle inoperabl hastalarda erken tanı
doğruluğunu artırmada faydalı olabilir.

References

  • 1. Spiro SG, Porter JC. Lung cancer-Where are we today? Current advances in staging and nonsurgical treatment. Am J Respir Crit Care Med 2002; 166: 1166-96.
  • 2. Parkin GM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin 1999; 49: 33- 64.
  • 3. Kanser bildirimlerinin değerlendirilmesi 1993-1994. T.C. Sağlık Bakanlığı Kanser Savaş Daire başkanlığı. Yayın no:582, Ankara 1997.
  • 4. Bray F, Pisani P, Parkin DM. GLOBOCAN 2002. Cancer Incidence, Mortality and Prevalance Worldwide, Descriptive Epidemiology Group. IARC CancerBase No. 5, version 2.0, IARCPress, Lyon, 2004.
  • 5. Smith RA, Glynn TJ. Epidemiology of lung cancer. Radiol Clin North Am 2000; 38: 453- 70.
  • 6. Sone S, Takashima S, Li F et al. Mass screening for lung cancer with mobile spiral computed tomography scanner. Lancet 1998; 351: 1242–45.
  • 7. Henschke CI, McCauley DI, Yankelevitz DF et al. Early lung cancer action project: a summary of the findings on baseline screening. Oncologist 2001; 6: 147–52.
  • 8. Geraghty PR, Kee ST, McFarlane G, Razavi MK, Sze DY, Dake MD. CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. Radiology 2003; 229: 475–81.
  • 9. Kato R, Katada K, Anno H, Suzuki S, Ida Y, Koga S. Radiation dosimetry at CT fluoroscopy: physician’s hand dose and development of needle holders. Radiology 1996;201: 576–78.
  • 10. Baaklini W, Reinoso M, Gorin A, Sharafkaneh A, Manian P. Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest 2000; 117: 1049–54.
  • 11. Cortese DA, McDougall JC. Biopsy and brushing of peripheral lung cancer with fluoroscopic guidance. Chest 1979; 75: 141–45.
  • 12. Laurent F, Michel P, Latrabe V, Tunon de Lara M, Marthan R. Pneumothoraces and chest tube placement after CT-guided transthoracic lung biopsy using a coaxial technique: incidence and risk factors. AJR Am J Roentgenol 1999; 172: 1049–53.
  • 13. Merritt SA, Gibbs JD , Yu KC , Patel V , Rai L, Cornish DC, Bascom R, Higgins WE. Image-Guided Bronchoscopy for Peripheral Lung Lesions* A Phantom Study. CHEST 2008; 134:1017–1026.
  • 14. Eberhardt R, Kahn N, Gompelmann D, Schumann M, Heussel CP, Herth FJ. LungPoint-a new approach to peripheral lesions. J. Thorac. Oncol. 2010; 5: 1559–63.
  • 15. Ross JB, Phoneix AZ. ATS 2010 IC, Session A44, poster G59.
  • 16. Herth FJF, Gompelmann D, Kahn N, Eberhardt R. ATS 2010 IC. Session A44, poster G54.
  • 17. Leong S, Ju H, Marshall H, Bowman R, Yang I, Ree AM, Saxon C, Fong KM. Electromagnetic navigation bronchoscopy: A descriptive analysis. J Thorac Dis 2012; 4: 173-85.
  • 18. Makris D, Scherpereel A, Leroy S et al. Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions. Eur Respir J 2007; 29: 1187-92.
  • 19. Seijo LM, de Torres JP, Lozano MD et al. Diagnostic yield of electromagnetic navigation bronchoscopy is highly dependent on the presence of a Bronchus sign on CT imaging: results from a prospective study. Chest 2010; 138: 1316-21.
  • 20. Wilson DS, Bartlett RJ. Improved Diagnostic Yield of Bronchoscopy in a Community Practice: Combination of Electromagnetic Navigation System and Rapid On-site Evaluation. J Bronchol 2007; 14: 227-32.
  • 21. Becker HD, Harms W, Debus J, Bruekner D, McLemore T. Brachytherapy of inoperable peripheral lung cancer guided by electromagnetic navigation and endobronchial ultrasound: Feasibility study and confirmation by longterm results at two centers. Chest Meeting Abstracts 2009; 136: 2.
  • 22. Hautmann H, Schneider A, Pinkau T, Peltz F, Feussner H. Electromagnetic catheter navigation during bronchoscopy: validation of a novel method by conventional fluoroscopy. Chest 2005; 128: 382-7.
  • 23. Gildea TR, Mazzone PJ, Karnak D, Meziane M, Mehta AC. Electromagnetic navigation diagnostic bronchoscopy: a prospective study. Am J Respir Crit Care Med 2006; 174: 982-89.
  • 24. Schwarz Y, Mehta AC, Ernst A et al. Electromagnetic navigation during flexible bronchoscopy. Respiration 2003; 70: 516-22.
  • 25. Lamprecht B, Porsch P, Pirich C, Studnicka M. Electromagnetic navigation bronchoscopy in combination with PET-CT and rapid on-site cytopathologic examination for diagnosis of peripheral lung lesions. Lung 2009; 187: 55-59.
  • 26. Bertoletti L, Robert A, Cottier M, Chambonniere ML, Vergnon JM. Accuracy and feasibility of electromagnetic navigated bronchoscopy under nitrous oxide sedation for pulmonary peripheral opacities: an outpatient study. Respiration 2009; 78: 293-300.
  • 27. Eberhardt R, Anantham D, Ernst A, Feller-Kopman D, Herth F. Multimodality bronchoscopic diagnosis of peripheral lung lesions: a randomized controlled trial. Am J Respir Crit Care Med 2007; 176: 36-41.
  • 28. Paone G, Nicastri E, Lucantoni G et al. Endobronchial ultrasound-driven biopsy in the diagnosis of peripheral lung lesions. Chest 2005; 128: 3551-57.
  • 29. Naidich DP, Sussman R, Kutcher WL, Aranda CP, Garay SM, Ettenger NA. Solitary pulmonary nodules. CT-bronchoscopic correlation. Chest 1988; 93: 595-98.
  • 30. Becker HD, Herth F, Ernst A, Schwarz Y. Bronchoscopic Biopsy of Peripheral Lung Lesions Under Electromagnetic Guidance: A Pilot Study. J Bronchology 2005; 12: 9-13.
  • 31. Eberhardt R, Anantham D, Herth F, Feller-Kopman D, Ernst A. Electromagnetic navigation diagnostic bronchoscopy in peripheral lung lesions. Chest 2007; 131: 1800-5.
  • 32. Schwar z Y, Greif J, Becker HD, Ernst A, Mehta A. Real-time electromagnetic navigation bronchoscopy to peripheral lung lesions using overlaid CT images: the first human study. Chest 2006; 129: 988-94.
  • 33. Naidich DP, Sussman R, Kutcher WL, Aranda CP, Garay SM, Ettenger NA. Solitary pulmonary nodules. CT-bronchoscopic correlation. Chest 1988; 93: 595-98.
  • 34. Seijo LM, de Torres JP, Lozano MD et al. Diagnostic yield of electromagnetic navigation bronchoscopy is highly dependent on the presence of a Bronchus sign on CT imaging: results from a prospective study. Chest 2010; 138: 1316-21.
  • 35. Steinfort DP, Khor YH, Manser RL, Irving LB. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis. Eur Respir J 2011; 37: 902-10.
  • 36. Schroeder C, Hejal R, Linden PA. Coil spring fiducial markers placed safely using navigation bronchoscopy in inoperable patients allows accurate delivery of CyberKnife stereotactic radiosurgery. J Thorac Cardiovasc Surg 2010; 140: 1137-42.
There are 36 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Revıew Artıcle
Authors

Serda Kanbur Metin 0000-0003-3983-9420

Çağatay Tezel This is me 0000-0001-5272-6215

Publication Date September 30, 2018
Published in Issue Year 2018

Cite

APA Kanbur Metin, S., & Tezel, Ç. (2018). Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB). Turkish Journal of Clinics and Laboratory, 9(3), 237-243. https://doi.org/10.18663/tjcl.356585
AMA Kanbur Metin S, Tezel Ç. Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB). TJCL. September 2018;9(3):237-243. doi:10.18663/tjcl.356585
Chicago Kanbur Metin, Serda, and Çağatay Tezel. “Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB)”. Turkish Journal of Clinics and Laboratory 9, no. 3 (September 2018): 237-43. https://doi.org/10.18663/tjcl.356585.
EndNote Kanbur Metin S, Tezel Ç (September 1, 2018) Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB). Turkish Journal of Clinics and Laboratory 9 3 237–243.
IEEE S. Kanbur Metin and Ç. Tezel, “Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB)”, TJCL, vol. 9, no. 3, pp. 237–243, 2018, doi: 10.18663/tjcl.356585.
ISNAD Kanbur Metin, Serda - Tezel, Çağatay. “Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB)”. Turkish Journal of Clinics and Laboratory 9/3 (September 2018), 237-243. https://doi.org/10.18663/tjcl.356585.
JAMA Kanbur Metin S, Tezel Ç. Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB). TJCL. 2018;9:237–243.
MLA Kanbur Metin, Serda and Çağatay Tezel. “Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB)”. Turkish Journal of Clinics and Laboratory, vol. 9, no. 3, 2018, pp. 237-43, doi:10.18663/tjcl.356585.
Vancouver Kanbur Metin S, Tezel Ç. Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB). TJCL. 2018;9(3):237-43.


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