Mobile Cone-Beam CT-Assisted Bronchoscopy for Peripheral Lung Lesions

Area of Science:

• Pulmonology
• Medical Imaging
• Interventional Procedures

Background:

• Peripheral bronchoscopy using thin/ultrathin scopes and radial-probe endobronchial ultrasound (RP-EBUS) has a fair diagnostic yield for peripheral lung lesions.
• Mobile cone-beam CT (m-CBCT) is a developing technology that may enhance the performance of these bronchoscopic tools.

Purpose of the Study:

• To evaluate the diagnostic performance and safety of combining thin/ultrathin bronchoscopy, RP-EBUS, and m-CBCT for peripheral lung lesions.
• To assess the diagnostic yield and sensitivity for malignancy of this integrated approach.

Main Methods:

• Retrospective review of 51 patients undergoing bronchoscopy for peripheral lung lesions.
• Guidance utilized thin/ultrathin bronchoscopes, RP-EBUS, and m-CBCT.
• Analysis of diagnostic yield, sensitivity for malignancy, complication rates, and radiation exposure.

Main Results:

• The combined approach achieved a diagnostic yield of 78.4% and a sensitivity for malignancy of 77.4%.
• The mean target lesion size was 2.6 cm, and the mean distance to the pleura was 1.5 cm.
• One pneumothorax was the only complication; median fluoroscopy time was 11.2 minutes.

Conclusions:

• Mobile cone-beam CT guidance can safely enhance the diagnostic performance of thin/ultrathin bronchoscopy for peripheral lung lesions.
• Further prospective studies are recommended to validate these findings.