Electromagnetic Navigational Bronchoscopy Learning Curve Regarding Pneumothorax Rate and Diagnostic Yield

Area of Science:

• Pulmonology
• Medical Technology
• Diagnostic Imaging

Background:

• Electromagnetic navigational bronchoscopy (ENB) is an advanced technique for diagnosing lung nodules.
• Pneumothorax is a known complication of ENB procedures.
• Optimizing ENB requires evaluating diagnostic yield and complication rates.

Purpose of the Study:

• To assess the diagnostic yield and pneumothorax rates of ENB over four years.
• To explore the impact of procedural experience (learning curve) on ENB outcomes.
• To identify potential areas for improvement in ENB procedures.

Main Methods:

• Retrospective analysis of 358 peripheral lung biopsies from 246 patients undergoing ENB.
• Data collected from Castle Hill Hospital, UK, between 2020 and 2023.
• Comparison of diagnostic yield and pneumothorax rates between two two-year periods.

Main Results:

• Overall diagnostic yield was 61.3%.
• Diagnostic yield increased from 58.2% (2020-2021) to 66.0% (2022-2023).
• Pneumothorax rate significantly decreased from 9.8% to 3.4% (p=0.021), particularly in upper lobe procedures.

Conclusions:

• Procedural experience significantly improves ENB diagnostic yield and safety.
• Technological advancements, like robotic assistance, may further enhance ENB reproducibility.
• ENB is a valuable tool for lung lesion diagnosis, with potential for optimization.