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A new interesting article has been published in Respirology. 2019 Jul 2. doi: 10.1111/resp.13609. and titled:

Improved diagnostic yield for lung nodules with digital tomosynthesis-corrected navigational bronchoscopy: Initial experience with a novel adjunct.

Authors of this article are:

Aboudara M, Roller L, Rickman O, Lentz RJ, Pannu J, Chen H, Maldonado F.

A summary of the article is shown below:

BACKGROUND AND OBJECTIVE: The diagnostic yield of electromagnetic navigation bronchoscopy (ENB) is inferior to that of computed tomography (CT)-guided needle biopsy for pulmonary nodules. One explanation for this is divergence between the nodule location on the pre-procedure CT scan and its actual location during the procedure. Fluoroscopic ENB (F-ENB) consists of digital tomosynthesis using a conventional C-arm to re-register the target lesion based on near real-time imaging. We performed a retrospective review of ENB cases at our institution before and after introduction of F-ENB to assess diagnostic yield.METHODS: All consecutive ENB procedures performed at our institution from 25 December 2017 to 25 August 2018 were reviewed. F-ENB was introduced on 25 April 2018. Two cohorts were analysed: standard ENB (S-ENB) from 25 December 2017 to 24 April 2018 and F-ENB from 25 April 2018 to 25 August 2018. All procedural, demographic and diagnostic data were collected. Descriptive statistics, chi-square, Wilcoxon test and Student’s t-test were used where appropriate. A multivariable regression analysis was performed to assess factors associated with diagnostic yield.RESULTS: A total of 101 and 67 nodules were biopsied in the S-ENB and F-ENB groups, respectively. Diagnostic yield was 54% in S-ENB cohort and 79% in the F-ENB group (P = 0.0019). Factors independently associated with a positive diagnosis were F-ENB and a positive radial ultrasound view (odds ratio (OR): 3.57, 95% CI: 1.56-8.18 and OR: 3.74, 95% CI: 1.37-11.05, respectively). Complications were minimal (pneumothorax: 1.5%).CONCLUSION: The use of F-ENB may increase the diagnostic yield of ENB and has a low complication rate.© 2019 Asian Pacific Society of Respirology.

Check out the article’s website on Pubmed for more information:

[link-preview url=https://www.ncbi.nlm.nih.gov/pubmed/31265204 forceshot=true]

This article is a good source of information and a good way to become familiar with topics such as: fluoroscopy;lung nodule;navigational bronchoscopy;tomosynthesis.

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