Comparison of Synapse 3D system (Version 4.4) and DirectPath system (Version 2.0) in virtual bronchoscopic navigation...

Area of Science:

• Pulmonology
• Medical Imaging
• Interventional Pulmonology

Background:

• Virtual bronchoscopic navigation (VBN) systems aid in diagnosing peripheral pulmonary nodules (PPNs).
• Comparative effectiveness of different VBN systems for transbronchial biopsy (TBB) diagnostic yield is not well-established.

Purpose of the Study:

• To compare the Synapse 3D and DirectPath VBN systems for PPN diagnosis.
• Evaluate differences in bronchial tree reconstruction, navigation planning, and TBB success rates.

Main Methods:

• Retrospective study with self-paired and retrospective cohort designs.
• Analyzed 289 patients undergoing VBN-assisted TBB of PPNs using Synapse 3D (Group S) and DirectPath (Group D).
• Compared bronchial tree reconstruction, navigation pathway planning, localization success, and diagnostic yield.

Main Results:

• Synapse 3D showed superior bronchial tree reconstruction quality (p<0.001).
• Navigation planning was longer in Group S (1.35s vs 1.04s, p<0.001) but had a higher automated success rate (36.7% vs 19.7%, p<0.001).
• No significant differences in localization success rate (85.3% vs 91.2%) or diagnostic yield (67.6% vs 61.8%) between systems (p>0.05).

Conclusions:

• Both Synapse 3D and DirectPath VBN systems have distinct advantages.
• Localization success and diagnostic yield for VBN-assisted TBB were comparable between the two systems.
• Improving VBN segmentation algorithms and optimizing CT data utilization may enhance efficiency, particularly for less experienced physicians.