Intraprocedural computed tomography-guided navigation with ventilatory strategy for atelectasis (ICNVA): a modified...

Area of Science:

• Pulmonology
• Medical Imaging
• Interventional Pulmonology

Background:

• Computed tomography (CT)-body divergence significantly impacts the accuracy of electromagnetic navigation bronchoscopy (ENB) for diagnosing peripheral lung lesions.
• A novel technique, intraprocedural CT-guided navigation with ventilatory strategy for atelectasis (ICNVA)-ENB, was developed to address this limitation.

Purpose of the Study:

• To evaluate the safety and accuracy of the ICNVA-ENB technique in patients with peripheral lung lesions.
• To assess the reduction in CT-to-body divergence achieved by the ICNVA-ENB approach compared to traditional ENB.

Main Methods:

• A retrospective observational study involving ten patients with peripheral pulmonary lesions underwent ICNVA-ENB.
• Intraoperative CT data were utilized for real-time path planning, and a specific ventilation strategy was employed to maintain lung inflation and reduce divergence.
• Accuracy was assessed by measuring the distance between the ENB probe and the lesion, comparing rapid on-site evaluation (ROSE) with pathology, and calculating CT-to-body divergence.

Main Results:

• The mean distance between the navigation probe and the lesion center was 5.90±1.73 mm.
• Rapid on-site evaluation (ROSE) results were consistent with postoperative pathology in 90% of cases.
• ICNVA-ENB demonstrated significantly reduced CT-to-body divergence (6.60±2.59 mm) compared to traditional ENB (12.10±3.67 mm, P<0.01).
• The average procedure time was 29.30±10.14 minutes, with one instance of slight intrapulmonary hemorrhage.

Conclusions:

• ICNVA-ENB effectively reduces CT-to-body divergence, enhancing the accuracy of peripheral lung lesion diagnosis.
• The ICNVA-ENB technique is demonstrated to be safe and accurate for interventional pulmonology procedures.