Electromagnetic navigational bronchoscopy in patients with solitary pulmonary nodules

Copeland, Samuel; Kambali, Shrinivas; Berdine, Gilbert; Alalawi, Raed

doi:10.12746/swrccc2017.0517.235

Cited by 5 publications

(3 citation statements)

References 2 publications

(2 reference statements)

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“…Use of extensive biopsy tool strategies, including use of the aspirating needle, did not increase complication rates. These results are consistent with prior reports of improved diagnostic yield using the aspirating needle compared with other transbronchial methods 16–18,27,28. The AQuIRE registry reported that the aspiration needle improved diagnostic yield compared with transbronchial brushing, forceps biopsy, or lavage 9.…”

Section: Discussionsupporting

confidence: 89%

“…These results are consistent with prior reports of improved diagnostic yield using the aspirating needle compared with other transbronchial methods. [16][17][18]27,28 The AQuIRE registry reported that the aspiration needle improved diagnostic yield compared with transbronchial brushing, forceps biopsy, or lavage. 9 Use of needle aspiration in only 16% of AQuIRE By design, all lesions included in this analysis were ultimately proven to be positive for malignancy based on final pathology results of the ENB-aided sample.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 Operator and procedural factors may further impact outcomes, such as user experience, 16 the use of rapid on-site evaluation (ROSE), 11,17,18 and concurrent imaging. 15,[19][20][21][22] Previous studies suggest that the diagnostic yield of bronchoscopy, including conventional bronchoscopy, 9,23,24 virtual bronchoscopic navigation, 25,26 and ENB, 20,27,28 may be related to the choice of biopsy tool. In particular, several studies have reported higher diagnostic yield with transbronchial needle aspiration than with transbronchial forceps biopsy or brushing.…”

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confidence: 99%

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The Impact of Biopsy Tool Choice and Rapid On-Site Evaluation on Diagnostic Accuracy for Malignant Lesions in the Prospective

Gildea

Folch

Khandhar³

et al. 2020

Journal of Bronchology &Amp; Interventional Pulmonology

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Background: The diagnostic yield of electromagnetic navigation bronchoscopy (ENB) is impacted by biopsy tool strategy and rapid on-site evaluation (ROSE) use. This analysis evaluates usage patterns, accuracy, and safety of tool strategy and ROSE in a multicenter study. Methods: NAVIGATE (NCT02410837) evaluates ENB using the superDimension navigation system (versions 6.3 to 7.1). The 1-year analysis included 1215 prospectively enrolled subjects at 29 United States sites. Included herein are 416 subjects who underwent ENB-aided biopsy of a single lung lesion positive for malignancy at 1 year. Use of a restricted number of tools (only biopsy forceps, standard cytology brush, and/or bronchoalveolar lavage) was compared with an extensive multimodal strategy (biopsy forceps, cytology brush, aspirating needle, triple needle cytology brush, needle-tipped cytology brush, core biopsy system, and bronchoalveolar lavage). Results: Of malignant cases, 86.8% (361/416) of true positive diagnoses were obtained using extensive multimodal strategies. ROSE was used in 300/416 cases. The finding of malignancy by ROSE reduced the total number of tools used. A malignant ROSE call was obtained in 71% (212/300), most (88.7%; 188/212) by the first tool used (49.5% with aspirating needle, 20.2% with cytology brush, 17.0% with forceps). True positive rates were highest for the biopsy forceps (86.9%) and aspirating needle (86.6%). Use of extensive tool strategies did not increase the rates of pneumothorax (5.5% restricted, 2.8% extensive) or bronchopulmonary hemorrhage (3.6% restricted, 1.1% extensive). Conclusion: These results suggest that extensive biopsy tool strategies, including the aspirating needle, may provide higher true positive rates for detecting lung cancer without increasing complications.

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Section: Discussionsupporting

confidence: 89%