Diagnostic yield of electromagnetic navigational bronchoscopy

Area of Science:

• Pulmonology
• Interventional Pulmonology
• Diagnostic Imaging

Background:

• Peripheral lung nodules (PLNs) present diagnostic challenges.
• Electronavigational bronchoscopy (ENB) is a safe procedure to increase diagnostic yield for PLNs.
• Factors influencing ENB diagnostic yield require further investigation.

Purpose of the Study:

• To assess the impact of nodule characteristics and prior workup on ENB diagnostic yield.
• To identify predictors of successful ENB in diagnosing peripheral lung nodules.

Main Methods:

• Retrospective review of 98 ENB procedures in 92 patients.
• Analysis of factors including bronchus sign, ground glass opacification (GGO), distance from pleura, and prior endobronchial ultrasound (EBUS) or positron emission tomography (PET) scans.
• Logistic regression analysis to determine the impact of these factors on diagnostic yield.

Main Results:

• The overall diagnostic yield for ENB was 60%.
• A bronchus sign was present in 60% of cases, and GGO in 6%.
• Pneumothorax occurred in 6% of procedures. The odds ratio for diagnostic yield with a bronchus sign was 1.89 and with GGO was 4.51.

Conclusions:

• ENB demonstrated a 60% diagnostic yield with a 6% pneumothorax rate in this cohort.
• The presence of a bronchus sign showed a trend towards improved diagnostic yield, though not statistically significant.
• Larger studies are needed to validate the bronchus sign as a predictor of ENB success.