Clinical application of virtual bronchoscopic navigation system for peripheral lung lesions

Area of Science:

• Pulmonology
• Medical Imaging
• Interventional Pulmonology

Background:

• Transbronchial lung biopsy is crucial for diagnosing peripheral lung lesions but often has unsatisfactory diagnostic yields.
• Endobronchial ultrasound with guide sheath (EBUS-GS) enhances biopsy targeting, yet optimal bronchus selection relies heavily on individual operator skill.
• Virtual bronchoscopic navigation (VBN) systems offer potential improvements in procedural efficiency and accuracy.

Purpose of the Study:

• To evaluate the diagnostic yield and time efficiency of using virtual bronchoscopic navigation (VBN) with endobronchial ultrasound with guide sheath (EBUS-GS) for peripheral lung lesion biopsies.
• To compare the performance of VBN/EBUS-GS against EBUS-GS alone in terms of diagnostic yield and time to target determination.

Main Methods:

• A comparative study involving 57 cases using VBN/EBUS-GS and 55 cases using EBUS-GS.
• VBN system utilized CT-derived virtual bronchoscopic images to map ideal routes to target lesions.
• EBUS-GS was employed to confirm the accuracy of the navigated route before biopsy.

Main Results:

• The diagnostic yield was comparable between the groups: 84.2% for VBN/EBUS-GS and 80.0% for EBUS-GS.
• The time required to determine the biopsy position was significantly reduced in the VBN/EBUS-GS group (5.54 ± 0.57 min) compared to the EBUS-GS group (9.27 ± 0.86 min) (P<0.01).

Conclusions:

• Virtual bronchoscopic navigation (VBN) is a valuable tool for enhancing the efficiency of peripheral lung lesion biopsies.
• VBN significantly shortens the time needed to identify biopsy targets when used in conjunction with EBUS-GS.
• The integration of VBN with EBUS-GS improves procedural workflow without negatively impacting diagnostic accuracy.