Peripheral Lung Nodule Diagnosis and Fiducial Marker Placement Using a Novel Tip-Tracked Electromagnetic Navigation Bronchoscopy System

Abstract

This novel tip-tracked EMN system incorporating both ENB and EMTTNA can guide biopsy and FM placement with a high degree of success and with a low complication rate. Multicentered prospective trials are required to develop algorithmic approaches to combine ENB and EMTTNA into a single procedure.

Endobronchial coil spring fiducial markers for CyberKnife® stereotactic body radiation therapy

“…Other large retrospective series focusing on endobronchial FM placement in peripheral nodules 12,13 included a number of patients similar to our study. We observed a 50–70% lower migration rate compared to previously published conventional linear‐gold FM series (18–20%), 13–16 but a higher migration rate compared to cs‐FM airway deployment using ENB (<1%) 10,12 . Our data suggest that non‐linear FM should be preferred to the linear ones for PPL marking.…”

“…The reported rate of complications is low. Pneumothorax occurs in 0–6% of cases and is associated with guided transbronchial biopsies (TBB) performed before FM insertion 10–13 …”

“…Subsequently, non‐linear FM have been developed to reduce the migration rate. In one study, describing ENB‐guided placement of nitinol wire attached to a gold seed, CT scan simulation resulted in an FM migration rate of less than 1% 12 . A preliminary study described a multimodal guidance technique combining virtual bronchoscopy with ENB to place nine two‐band FM (superLock superDimension Ltd, Minneapolis, MN, USA) and showed no migration 17 …”

Compensation of dynamic electromagnetic field distortion using simultaneous localization and mapping method with application in endobronchial ultrasound‐transbronchial needle aspiration (EBUS‐TBNA) guidance

“…Transbronchial needle aspiration under electromagnetic tracking guidance in the procedure of peripheral lung lesions sampling improves the diagnosis rate, and using an EM navigated CP‐EBUS system in the process of EBUS‐TBNA enhances the accuracy of the peripheral lesions localization . However, the susceptibility of EMT systems to metallic objects is still a challenging issue, additionally dynamic errors resulting from bronchial movement decrease the accuracy of TBNA tracking in electromagnetic navigation systems.…”

Evaluation of a bronchoscopy guidance system for bronchoscopy training, a randomized controlled trial

“…However, a major drawback is the absence of feedback information: An inexperienced examiner can be expected to lose orientation during the examination without supervision or proper training. One possibility for giving feedback could be the use of spatial information by means of Electromagnetic Navigation Bronchoscopy (ENB) [24]. This new method has already been evaluated in several studies, e.g.…”