Endobronchial ultrasound and electromagnetic navigation bronchoscopy in the diagnosis of peripheral lung lesions

Unfortunately, flexible bronchoscopy, the least invasive bronchoscopic procedure, is of limited value for obtaining tissue from lesions in the peripheral segments of the lung. Biopsy success is compromised further if the lesion is < 2 cm in diameter. The main limitation of flexible bronchoscopy is the difficulty in reaching peripheral lesions with the accessory tools.

Once extended beyond the tip of the bronchoscope, these tools are difficult to guide to the desired location. Localizing the lesion under fluoroscopy is difficult, and alternative diagnostic guidance methods, such as computer tomography-guided bronchoscopy and endobronchial ultrasound, are more demanding. Therefore, new methods for navigation and localization are needed. One of these new technologies is the use of endobronchial ultrasound miniprobes followed by a guided biopsy. The other is electromagnetic navigation bronchoscopy.

The aim of the systematic review is to provide an analysis of the published literature.

Both systems showed an increased yield in diagnosing solitary pulmonary nodules. The body of evidence is growing rapidly. The ultimate goal of reliable and minimally invasive biopsy of peripheral lung lesions now appears feasible.