Efficacy and safety of virtual bronchoscopic navigation with fused fluoroscopy and vessel mapping for access of pulmonary lesions

Jiayuan Sun, Gerard J. Criner, David Dibardino, Shiyue Li, Daniel Nader, Bing Lam, Lisa Kopas, Momen M. Wahidi, Adnan Majid, Robert Marron, Steven Verga, Felix J.F. Herth

Research output: Contribution to journalArticlepeer-review

Abstract

Background and objective: Virtual bronchoscopic navigation (VBN) with fused fluoroscopy and vessel mapping provides a point of entry (POE) for puncturing airway wall to biopsy lesions. The study was designed to evaluate the safety and efficacy of this technology to diagnose peripheral pulmonary lesions. Methods: It was a prospective, single-arm, multicentre study. Patients underwent lesions biopsy with the Archimedes® VBN System via a POE using one of the two techniques: (1) bronchoscopic transparenchymal nodule access (BTPNA) and (2) guided transbronchial needle aspiration (TBNA). Biopsy yield, sampling yield and diagnostic yield were mainly determined in lesions biopsy attempted. Results: One hundred and thirty patients underwent anaesthesia and constituted the intention-to-treat population. One hundred and four patients with 114 lesions had biopsy attempted. Mean lesion size was 2.4 ± 1.13 cm. Sufficient tissue samples were obtained from 86 lesions with a biopsy yield of 75.4%. Nevertheless, sufficient samples for diagnosis based on histology ± cytology were obtained from 107 lesions with a sampling yield of 93.9%. Follow-up was conducted for more than 1 year, with a diagnostic yield of 75.4% and 72.8%, respectively, on high and low estimate with consideration of three lesions without follow-up. Two (1.9%) pneumothoraxes and one (1.0%) mild bleeding occurred. Conclusion: BTPNA and guided TBNA contribute to safe and effective sampling of peripheral pulmonary lesions. A relatively high biopsy yield was obtained independent of the presence or absence of a bronchus sign (BS), and high sampling yield and diagnostic yield were obtained independent of location, lesion size and presence or absence of a BS.

Original languageEnglish (US)
Pages (from-to)357-365
Number of pages9
JournalRespirology
Volume27
Issue number5
DOIs
StatePublished - May 2022

Keywords

  • bronchoscopic transparenchymal nodule access
  • point of entry
  • pulmonary lesion
  • virtual bronchoscopic navigation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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