Virtual fluoroscopic preprocedural planning using Ziostation2 for transbronchial biopsy: A prospective...

Area of Science:

• Pulmonology
• Medical Imaging
• Interventional Bronchoscopy

Background:

• Bronchoscope limitations in reaching peripheral lung targets due to tapered bronchi.
• Challenges in selectively advancing devices like endobronchial ultrasonography (EBUS) probes to target lesions.
• Introduction of Virtual Fluoroscopic Preprocedural Planning (VFPP) integrated into the Ziostation2 navigation system.

Purpose of the Study:

• To prospectively evaluate the feasibility and effectiveness of the Ziostation2-integrated VFPP (Zio-VFPP) method.
• To assess the impact of Zio-VFPP on the accuracy of EBUS probe advancement.
• To compare EBUS findings before and after the implementation of Zio-VFPP.

Main Methods:

• Prospective study involving 36 patients with pulmonary lesions (≤30 mm long axis) undergoing thin-slice CT scans.
• Bronchoscopy initiated using EBUS with a guide sheath (EBUS-GS) with Ziostation2 navigation.
• Position correction attempts using Zio-VFPP when the EBUS probe was not within the lesion; comparison of EBUS findings pre- and post-Zio-VFPP.

Main Results:

• Zio-VFPP was performed in 24 patients, leading to improved EBUS findings in nine.
• The number of patients with the EBUS probe "outside" the lesion decreased significantly from 18 to ten (p=0.0392).
• No cases showed worsened EBUS findings after Zio-VFPP implementation.

Conclusions:

• Zio-VFPP demonstrates effectiveness in improving EBUS findings and reducing instances of the probe being outside the target lesion.
• The study suggests Zio-VFPP is a valuable tool for enhancing bronchoscopic navigation.
• Further research is warranted to fully validate the clinical utility and effectiveness of Zio-VFPP.