Shape-Sensing Robotic-Assisted Bronchoscopy with Concurrent use of Radial Endobronchial Ultrasound and Cone Beam Computed Tomography in the Evaluation of Pulmonary Lesions

Styrvoky, Kim; Schwalk, Audra; Pham, David T; Chiu, Hsienchang; Rudkovskaia, Anastasiia; Madsen, Kristine A.; Carrio, Stephen; Kurian, Elizabeth; Casas, Luis De Las; Abu‐Hijleh, Muhanned

doi:10.1007/s00408-022-00590-7

Cited by 15 publications

(8 citation statements)

References 26 publications

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“…The addition of robotic technology with navigational bronchoscopy has allowed for improved precision and stability. The early reported diagnostic accuracy of ssRAB with advanced imaging ranges from 81.7 to 91.2%, with a low rate of complication [ [3] , [4] , [5] , [6] , [7] ]. A multicenter retrospective review of consecutive patients who underwent RAB versus CT-guided transthoracic biopsy (CTTB) for evaluating pulmonary lesions described a similar diagnostic yield between modalities (87.6% for RAB and 88.4% for CTTB).…”

Section: Discussionmentioning

confidence: 99%

Longitudinal use of three different navigational bronchoscopy systems to sample lung nodules in a single patient

Schwalk¹,

Styrvoky²

2023

Respiratory Medicine Case Reports

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Section: Discussionmentioning

confidence: 99%

Longitudinal use of three different navigational bronchoscopy systems to sample lung nodules in a single patient

Schwalk¹,

Styrvoky²

2023

Respiratory Medicine Case Reports

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“…Multiplanar 3D fluoroscopy during RAB was introduced to overcome this divergence, by providing imaging of the biopsy tool and allowing fine repositioning of the robotic tip toward the lesion within a safe range of radiation exposure [3,8]. The use of either shape-sensing or electromagnetic navigation RAB, with concurrent intraoperative imaging and rEBUS, has shown a diagnostic sensitivity of 77-91.7% [3,[9][10][11]. Although the combination of these two technologies requires an initial capital investment, the total cost of ssRABspecific supplies does not exceed $2,000 USD per procedure.…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Bronchoscopy Integrated with Three-Dimensional Fluoroscopy for Sampling Bilateral Pulmonary Nodules in a Single Procedure

et al. 2023

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Bronchoscopic biopsy of peripheral pulmonary nodules has evolved in recent years with the emergence of new technologies such as shape-sensing robotic-assisted bronchoscopy. The use of three-dimensional (3D) fluoroscopy for intraoperative visualization of the biopsy tool in relation to the target nodule aims to overcome computed tomography-to-body divergence encountered during the procedure and allows for more accurate sampling to improve adequacy and diagnostic performance. Until recently, the robotic-assisted navigation plan and 3D imaging function as separate systems. We present a case where intraoperative 3D fluoroscopy images were integrated to the robotic bronchoscopy navigation system, resulting in a single, dynamic, real-time 3D virtual plan showing readjusted paths toward the lesion displayed in the robotic bronchoscopy navigation system, allowing in this case, biopsying two bilateral pulmonary nodules, resulting in different diagnosis within the same endoscopic procedure.

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“…Although studies directly comparing CBCT-guided bronchoscopy to other bronchoscopic methods are limited in number, single-center studies have demonstrated significantly better diagnostic outcomes when CBCT guidance is added to EMN or ultrathin bronchoscopy with rEBUS than with either EMN or rEBUS alone [28 & ,29,30]. In addition, several recent case series of both fixed and mobile CBCT-guided robotic-assisted bronchoscopy furnished promising results, with diagnostic yields of up to 94% [23,24,[31][32][33].…”

Section: Cone Beam Computed Tomographymentioning

confidence: 99%

Imaging in peripheral bronchoscopy

Shaller,

Sethi,

Cicenia

2023

Current Opinion in Pulmonary Medicine

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Purpose of review Historically the sampling of peripheral lung lesions via bronchoscopy has suffered from inferior diagnostic outcomes relative to transthoracic needle aspiration, and neither a successful bronchoscopic navigation nor a promising radial ultrasonographic image of one's target lesion guarantees a successful biopsy. Fortunately, many of peripheral bronchoscopy's shortcomings – including an inability to detect and compensate for computed tomography (CT)-body divergence, and the absence of tool-in-lesion confirmation – are potentially remediable through the use of improved intraprocedural imaging techniques. Recent findings Recent advances in intraprocedural imaging, including the integration of cone beam CT, digital tomosynthesis, and augmented fluoroscopy into bronchoscopic procedures have yielded promising results. These advanced imaging modalities may improve the outcomes of peripheral bronchoscopy through the detection and correction of navigational errors, CT-body divergence, and malpositioned biopsy instruments. Summary The incorporation of advanced imaging is an essential step in the improvement of peripheral bronchoscopic procedures.

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Shape-Sensing Robotic-Assisted Bronchoscopy with Concurrent use of Radial Endobronchial Ultrasound and Cone Beam Computed Tomography in the Evaluation of Pulmonary Lesions

Cited by 15 publications

References 26 publications

Longitudinal use of three different navigational bronchoscopy systems to sample lung nodules in a single patient

Longitudinal use of three different navigational bronchoscopy systems to sample lung nodules in a single patient

Robotic-Assisted Bronchoscopy Integrated with Three-Dimensional Fluoroscopy for Sampling Bilateral Pulmonary Nodules in a Single Procedure

Imaging in peripheral bronchoscopy

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