A virtual bronchoscopic navigation system under X-ray fluoroscopy for transbronchial diagnosis of small peripheral pulmonary lesions

Tachihara, Motoko; Ishida, Takashi; Kanazawa, Kenya; Sugawara, Akiko; Watanabe, Kana; Uekita, Kumi; Moriya, Hideshige; Yamazaki, Koichi; Asano, Fumihiro; Munakata, Mitsuru

doi:10.1016/j.lungcan.2007.04.006

Cited by 56 publications

(39 citation statements)

References 30 publications

(75 reference statements)

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“…The diagnostic yield with a combination of VBN and X-ray fluoroscopy was reported to be between 62.5 and 78.7%, and that for lesions ≤2 cm was between 54.5 and 76.9% [29,30,31,32]. Non-X-ray fluoroscopy-guided ultrathin bronchoscopy was shown in a previous study to have a high diagnostic yield of 80.0%, although relatively large lesions observable by direct vision on ultrathin bronchoscopy were included [33].…”

Section: Clinical Applicationsmentioning

confidence: 99%

Virtual Bronchoscopic Navigation for Peripheral Pulmonary Lesions

2014

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Virtual bronchoscopic navigation (VBN) is a method in which the bronchoscope is guided on the bronchial route to a peripheral lesion using virtual bronchoscopic images. In reports on VBN for peripheral pulmonary lesions searched in PubMed as of November 2013, the diagnostic yield by ultrathin bronchoscopy in combination with computed tomography and VBN was within the range of 65.4-81.6%. Using endobronchial ultrasonography with a guide sheath (EBUS-GS) and VBN, it was between 63.3 and 84.4%, and using X-ray fluoroscopy and VBN, it was between 62.5 and 78.7%. The overall diagnostic yield was 73.8% [95% confidence interval (CI) 70.9-76.8%] and that for lesions ≤2 cm was 67.4% (95% CI 63.3-71.5%). These values indicate high diagnostic rates. In randomized comparative trials, the combination of VBN with EBUS-GS improved the diagnostic yield and shortened the examination time. The diagnostic yields for lesions in the right upper lobe, those invisible on posterior-anterior radiographs and those located in the peripheral third of the lung field were improved by VBN on ultrathin bronchoscopy in combination with X-ray fluoroscopy. The usefulness of VBN was also found on meta-analysis. Taken together, VBN is a promising navigational bronchoscopy method as it requires no specific training, has a low overall complication rate of 1.0% (95% CI 0.2-1.8%) and does not directly induce or cause severe complications. To maximize the full potential of VBN and promote its use, investigation of cases in which it is useful, determination of the optimum combination of procedures, a cost/benefit analysis and advancement of the VBN system are warranted.

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Section: Clinical Applicationsmentioning

confidence: 99%

Virtual Bronchoscopic Navigation for Peripheral Pulmonary Lesions

2014

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“…However, the actual clinical relevance of ultrathin bronchoscopes is low, as those have not yet proven diagnostic advantages over conventional bronchoscopes [10,11] and do not provide any steering mechanism. Also, Soper et al only considered comparatively simple trajectories consisting of one smooth, one-way motion from the trachea into the peripheral lung.…”

Section: Discussionmentioning

confidence: 99%

Deformable Registration of Bronchoscopic Video Sequences to CT Volumes with Guaranteed Smooth Output

Reichl

Luo

Menzel

et al. 2011

Lecture Notes in Computer Science

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Abstract. We present a novel approach to tracking of flexible bronchoscopes by modeling the output as spatially continuous over time. Bronchoscopy is a widespread clinical procedure for diagnosis and treatment of lung diseases and navigation systems are highly needed. Tracking of the bronchoscope can be regarded as a deformable registration problem. In our approach we use hybrid image-based and electromagnetic tracking, and the bronchoscope pose relative to CT data is interpolated using Catmull-Rom splines for position and SLERP for orientation.We evaluate the method using ground truth poses manually selected by experts, where mean inter-expert agreement was determined as 1.26 mm. For four dynamic phantom data sets, the accuracy of our method is between 4.13 and 5.93 mm and shown to be equivalent to previous methods. We significantly improve inter-frame smoothness from 2.35-3.08 mm to 1.08-1.51 mm. Our method provides a more realistic and physically plausible solution with significantly less jitter. This quantitative result is confirmed by video output, which is much more consistent and robust, with fewer occasions of tracking loss or unexpected movement.

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“…VBN systems have been developed and become commercially available. There have already been some studies on VBN [12,[17][18][19][20][21][22][23][24][25][26][27]. A randomized study on transbronchial biopsy when used together with EBUS/GS and X-ray fluoroscopy showed that VBN increased the diagnostic yield and reduced the examination time [25].…”

Section: Introductionmentioning

confidence: 99%

Virtual bronchoscopic navigation without X-ray fluoroscopy to diagnose peripheral pulmonary lesions: A randomized trial

Asano

Ishida

Shinagawa

et al. 2016

1.4 Interventional Pulmonology

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Background: Transbronchial biopsy for peripheral pulmonary lesions is generally performed under X-ray fluoroscopy. Virtual bronchoscopic navigation (VBN) is a method in which virtual images of the bronchial route to the lesion are produced based on CT images obtained before VBN, and the bronchoscope is guided using these virtual images, improving the diagnostic yield of peripheral pulmonary lesions. VBN has the possibility of eliminating the need for X-ray fluoroscopy in the bronchoscopic diagnosis of peripheral lesions. To determine whether VBN can be a substitute for X-ray fluoroscopy, a randomized multicenter trial (non-inferiority trial) was performed in VBN and X-ray fluoroscopy (XRF) -assisted groups.

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A virtual bronchoscopic navigation system under X-ray fluoroscopy for transbronchial diagnosis of small peripheral pulmonary lesions

Cited by 56 publications

References 30 publications

Virtual Bronchoscopic Navigation for Peripheral Pulmonary Lesions

Virtual Bronchoscopic Navigation for Peripheral Pulmonary Lesions

Deformable Registration of Bronchoscopic Video Sequences to CT Volumes with Guaranteed Smooth Output

Virtual bronchoscopic navigation without X-ray fluoroscopy to diagnose peripheral pulmonary lesions: A randomized trial

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