Digital tomosynthesis for navigational bronchoscopy: a clinical practice review

Area of Science:

• Pulmonary Medicine
• Radiology
• Interventional Pulmonology

Background:

• Low-dose computed tomography (LDCT) screening increases pulmonary nodule detection, aiding lung cancer mortality reduction.
• Traditional risk calculators and CT-guided transthoracic needle biopsy (TTNB) have limitations in nodule evaluation and biopsy.
• Navigational bronchoscopy (NB) offers a safer alternative for nodule assessment and lymph node evaluation.

Purpose of the Study:

• To review clinical practices for optimizing lung nodule management.
• To highlight advancements in navigational bronchoscopy for improved diagnostic yield.
• To emphasize overcoming CT-body divergence in bronchoscopic lung nodule biopsy.

Main Methods:

• Review of clinical practices and technological advancements in lung nodule diagnosis.
• Integration of enhanced imaging modalities such as digital tomosynthesis (DT) and cone beam CT (CBCT).
• Optimization of intraoperative ventilator techniques during navigational bronchoscopy.

Main Results:

• Digital tomosynthesis (DT) enhances procedural visualization in navigational bronchoscopy (NB).
• Integration of advanced imaging modalities shows promise in improving diagnostic yields.
• Optimized techniques aim to overcome CT-body divergence, improving localization and biopsy outcomes.

Conclusions:

• Advanced imaging technologies like DT and CBCT are crucial for improving NB accuracy.
• Optimizing ventilator techniques and integrating enhanced imaging can overcome CT-body divergence.
• Further research is essential to refine these approaches and enhance patient outcomes in lung nodule management.