The diagnostic value of lung biopsy guided by LungPoint virtual navigation and radial ultrasound in peripheral pulmonary nodules_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

YANG Li , WANG Hai , YU Dongmei , WANG Hao ,  GU Ye

Endoscopy Center, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China;

Corresponding author：

Keywords：

Endobronchial ultrasound; virtual bronchoscopic navigation; pulmonary nodules; diagnostic rate

DOI：

10.7507/1671-6205.202210050

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the diagnostic value of endobronchial ultrasound technology in combination with LungPoint virtual navigation system for pulmonary peripheral nodules. Methods Retrospective analysis of 317 patients with peripheral pulmonary nodules who underwent endobronchial ultrasound at the endoscopy center of Shanghai Pulmonary Hospital from January 2021 to March 2022 was used as the study population. They were divided into the endobronchial ultrasound group (EBUS-GS group) and the virtual navigation combined with endobronchial ultrasound group (VBN+EBUS-GS group) according to whether the path was planned with the LungPoint virtual navigation system preoperatively or not. The diagnostic rate, bronchoscopic arrival rate, arrival time, operation time and complications were compared between the EBUS-GS group and the VBN+EBUS-GS group, and the factors associated with the diagnostic rate of endobronchial ultrasound were analyzed. Results There were 101 malignant nodules and 216 benign nodules. The mean size of lung nodules was (1.9±0.7) cm and (1.8±0.6) cm in the EBUS-GS and VBN+EUBS-GS groups, respectively (P>0.05); The time to reach the lesions was 7 (5 - 9) and 4 (3 - 5) min, and the total operation time was 18 (16 - 20) and 16 (14 - 18) min, respectively (P<0.05). The arrival rates of endobronchial ultrasound in the two groups was 82.6% and 98.1% (P<0.05), respectively. The overall diagnostic rate, malignant nodule diagnostic rate and benign nodule diagnostic rate of the two groups were 61.3% vs. 64.8%, 67.9% vs. 68.6% and 57.6% vs. 63.1% respectively (P>0.05). There was one pneumothorax in the EBUS-GS group after examination (0.6%, 1/155). No complications such as hemoptysis or infection occurred in all patients. Conclusions LungPoint virtual navigation can significantly improve the arrival rate of lesions under endobronchial ultrasound, significantly reduce the arrival time of endobronchial ultrasound to the lesions and the total operation time, which is beneficial to improve the efficiency of clinical examination.

Citation： YANG Li, WANG Hai, YU Dongmei, WANG Hao, GU Ye. The diagnostic value of lung biopsy guided by LungPoint virtual navigation and radial ultrasound in peripheral pulmonary nodules. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(10): 698-703. doi: 10.7507/1671-6205.202210050 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Gould MK, Tang T, Liu IL, et al. Recent Trends in the Identification of Incidental Pulmonary Nodules. Am J Respir Crit Care Med, 2015, 192(10): 1208-1214.
3.	Church TR, Black WC, Aberle DR, et al. Results of initial low-dose computed tomographic screening for lung cancer. N Engl J Med, 2013, 368(21): 1980-1991.
4.	Baaklini WA, Reinoso MA, Gorin AB, et al. Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest, 2000, 117(4): 1049-1054.
5.	Heerink WJ, de Bock GH, de Jonge GJ, et al. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol, 2017, 27(1): 138-148.
6.	Yeow KM, Su IH, Pan KT, et al. Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest, 2004, 126(3): 748-754.
7.	Kurimoto N, Miyazawa T, Okimasa S, et al. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically. Chest, 2004, 126(3): 959-965.
8.	Lee SC, Kim EY, Chang J, et al. Diagnostic value of the combined use of radial probe endobronchial ultrasound and transbronchial biopsy in lung cancer. Thorac Cancer, 2020, 11(6): 1533-1540.
9.	Steinfort DP, Khor YH, Manser RL, et al. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis. Eur Respir J, 2011, 37(4): 902-910.
10.	Ali MS, Trick W, Mba BI, et al. Radial endobronchial ultrasound for the diagnosis of peripheral pulmonary lesions: a systematic review and meta-analysis. Respirology, 2017, 22(3): 443-453.
11.	Giri M, Puri A, Wang T, et al. Virtual bronchoscopic navigation versus non-virtual bronchoscopic navigation assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: a systematic review and meta-analysis. Ther Adv Respir Dis, 2021, 15: 1631370920.
12.	Xu CH, Wang Y, Li L, et al. Diagnostic value of virtual bronchoscopic navigation combined with endobronchial ultrasound guided transbronchial lung biopsy for peripheral pulmonary lesions. Technol Cancer Res Treat, 2021, 20: 1533033821989992.
13.	Steinfort DP, Bonney A, See K, et al. Sequential multimodality bronchoscopic investigation of peripheral pulmonary lesions. Eur Respir J, 2016, 47(2): 607-614.
14.	Oki M, Saka H, Kitagawa C, et al. Randomized study of endobronchial ultrasound-guided transbronchial biopsy: thin bronchoscopic method versus guide sheath method. J Thorac Oncol, 2012, 7(3): 535-541.
15.	Ettinger DS, Aisner DL, Wood DE, et al. NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 5.2018. J Natl Compr Canc Netw, 2018, 16(7): 807-821.
16.	Feng XT, Zhang Q, Luo FM, et al. Study design for a multicenter, randomized controlled trial evaluating the diagnostic value of ultrathin bronchoscope compared to thin bronchoscope without fluoroscopy for peripheral pulmonary lesions. J Thorac Dis, 2022, 14(5): 1663-1673.
17.	Huang CT, Ruan SY, Tsai YJ, et al. Experience improves the performance of endobronchial ultrasound-guided transbronchial biopsy for peripheral pulmonary lesions: a learning curve at a medical centre. PLoS One, 2017, 12(6): e179719.
18.	Li SJ, Yan WP, Chen ML, et al. Virtual bronchoscopic navigation without fluoroscopy guidance for peripheral pulmonary lesions in inexperienced pulmonologist. Chin J Cancer Res, 2020, 32(4): 530-539.
19.	Bo L, Li C, Pan L, et al. Diagnosing a solitary pulmonary nodule using multiple bronchoscopic guided technologies: a prospective randomized study. Lung Cancer, 2019, 129: 48-54.
20.	Evison M, Crosbie PA, Morris J, et al. Can computed tomography characteristics predict outcomes in patients undergoing radial endobronchial ultrasound-guided biopsy of peripheral lung lesions?. J Thorac Oncol, 2014, 9(9): 1393-1397.

1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Gould MK, Tang T, Liu IL, et al. Recent Trends in the Identification of Incidental Pulmonary Nodules. Am J Respir Crit Care Med, 2015, 192(10): 1208-1214.
3. Church TR, Black WC, Aberle DR, et al. Results of initial low-dose computed tomographic screening for lung cancer. N Engl J Med, 2013, 368(21): 1980-1991.
4. Baaklini WA, Reinoso MA, Gorin AB, et al. Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest, 2000, 117(4): 1049-1054.
5. Heerink WJ, de Bock GH, de Jonge GJ, et al. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol, 2017, 27(1): 138-148.
6. Yeow KM, Su IH, Pan KT, et al. Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest, 2004, 126(3): 748-754.
7. Kurimoto N, Miyazawa T, Okimasa S, et al. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically. Chest, 2004, 126(3): 959-965.
8. Lee SC, Kim EY, Chang J, et al. Diagnostic value of the combined use of radial probe endobronchial ultrasound and transbronchial biopsy in lung cancer. Thorac Cancer, 2020, 11(6): 1533-1540.
9. Steinfort DP, Khor YH, Manser RL, et al. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis. Eur Respir J, 2011, 37(4): 902-910.
10. Ali MS, Trick W, Mba BI, et al. Radial endobronchial ultrasound for the diagnosis of peripheral pulmonary lesions: a systematic review and meta-analysis. Respirology, 2017, 22(3): 443-453.
11. Giri M, Puri A, Wang T, et al. Virtual bronchoscopic navigation versus non-virtual bronchoscopic navigation assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: a systematic review and meta-analysis. Ther Adv Respir Dis, 2021, 15: 1631370920.
12. Xu CH, Wang Y, Li L, et al. Diagnostic value of virtual bronchoscopic navigation combined with endobronchial ultrasound guided transbronchial lung biopsy for peripheral pulmonary lesions. Technol Cancer Res Treat, 2021, 20: 1533033821989992.
13. Steinfort DP, Bonney A, See K, et al. Sequential multimodality bronchoscopic investigation of peripheral pulmonary lesions. Eur Respir J, 2016, 47(2): 607-614.
14. Oki M, Saka H, Kitagawa C, et al. Randomized study of endobronchial ultrasound-guided transbronchial biopsy: thin bronchoscopic method versus guide sheath method. J Thorac Oncol, 2012, 7(3): 535-541.
15. Ettinger DS, Aisner DL, Wood DE, et al. NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 5.2018. J Natl Compr Canc Netw, 2018, 16(7): 807-821.
16. Feng XT, Zhang Q, Luo FM, et al. Study design for a multicenter, randomized controlled trial evaluating the diagnostic value of ultrathin bronchoscope compared to thin bronchoscope without fluoroscopy for peripheral pulmonary lesions. J Thorac Dis, 2022, 14(5): 1663-1673.
17. Huang CT, Ruan SY, Tsai YJ, et al. Experience improves the performance of endobronchial ultrasound-guided transbronchial biopsy for peripheral pulmonary lesions: a learning curve at a medical centre. PLoS One, 2017, 12(6): e179719.
18. Li SJ, Yan WP, Chen ML, et al. Virtual bronchoscopic navigation without fluoroscopy guidance for peripheral pulmonary lesions in inexperienced pulmonologist. Chin J Cancer Res, 2020, 32(4): 530-539.
19. Bo L, Li C, Pan L, et al. Diagnosing a solitary pulmonary nodule using multiple bronchoscopic guided technologies: a prospective randomized study. Lung Cancer, 2019, 129: 48-54.
20. Evison M, Crosbie PA, Morris J, et al. Can computed tomography characteristics predict outcomes in patients undergoing radial endobronchial ultrasound-guided biopsy of peripheral lung lesions?. J Thorac Oncol, 2014, 9(9): 1393-1397.

Chinese Journal of Respiratory and Critical Care Medicine

The diagnostic value of lung biopsy guided by LungPoint virtual navigation and radial ultrasound in peripheral pulmonary nodules

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content