Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB)

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. CTguided 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.