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Published on: May 4, 2022
[Electromagnetic navigation bronchoscopy real-time guidance lung biopsy for the diagnosis of small peripheral
Yu Chen1, Shiyue Li1, Hanzhang Chen1
1State Key Lab of Respiratory Disease,National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
Objective:
To evaluate the diagnostic value and safety of electromagnetic navigation bronchoscopy real-time guidance lung biopsy (ENB-guided TBLB) of small peripheral lung lesions (diameter < 3 cm).
Methods:
Patients were selected by small peripheral pulmonary lesions (diameter < 3 cm) on thoracic CT in our hospital between September 1, 2011 and May 30, 2012. ENB-guided TBLB was performed by flexible bronchoscope, while fluoroscopy-guided lung biopsy was performed as a control. Then the diagnostic yield of ENB-guided and fluoroscopy-guided lung biopsy was compared. The final diagnosis was confirmed by pathologic examination of surgically removed lesions or by 12 month follow-up until clinical cure being confirmed. The intraoperative and postoperative complications were recorded.
Results:
Seventeen patients (11 males, 6 females) with 20 small peripheral pulmonary lesions all underwent ENB- guided TBLB. The patients' average age was (53 ± 14) yrs , and the lesions' average diameter was (1.8 ± 0.7) cm. Eleven patients finally received surgical resection, while other 6 patients received medical treatment and follow-up for more than 12 months to achieve clinical cure. Pathologic results showed that the diagnostic yield of ENB group was 80.0% (16/20) and that of the fluoroscopy group was 45.0% (9/20), the difference between the 2 groups being statistically significant (χ² = 5.227, P = 0.048). Subgroup analysis showed that, if the lesion diameter was 2-3 cm, the diagnostic yield between the 2 groups had no statistical difference (χ² = 0.000, P = 1.000), but if the lesion diameter was < 2 cm, the diagnostic yield of the 2 groups was statistically different (χ(2) = 8.224, P = 0.012). In the ENB method, the diagnostic yield between the diameter of 2-3 cm group and the < 2 cm group had no statistical difference (χ² = 0.208, P = 1.000). Analysis of the diagnostic yield of different navigation plan CT graph layer thickness showed that, the 1 cm group was higher than the 2 cm group (χ² = 6.111, P = 0.026). The diagnostic yield of lesions with "air bronchogram" was higher than that of lesions without "air bronchogram" (χ² = 6.111, P = 0.026).
Conclusion:
Electromagnetic navigation bronchoscopy real-time guidance lung biopsy for small peripheral pulmonary lesions is safe, and has higher diagnostic rate.
