ObjectiveTo explore the clinical application of the comprehensive guidance technologies, such as cone beam computed tomography (CBCT), virtual bronchoscopic navigation (VBN), and superimposed high-frequency jet ventilator for respiratory control in the biopsy of peripheral pulmonary nodules (PPNs). MethodsThe clinical information of 3 patients with PPNs diagnosed by CBCT combined with VBN and superimposed high frequency superposition jet ventilator in Shanghai Changhai Hospital were retrospectively analyzed. Results Clinical data of 3 patients were collected. The average diameter of PPNs was (25.3±0.3) mm with various locations in left and right lung. The first nodule was located in the apex of the left upper lung, and the biopsy was benign without malignant cells. The lesion was not enlarged during the 5-year follow-up. The second one was located in the left lingual lung, and the postoperative pathology was confirmed as mucosa-associated lymphoma. The third one was located in the anterior segment of the right upper lung. After the failure of endobronchial procedure, percutaneous PPNs biopsy under CBCT combined with VBN was performed, and the pathological diagnosis was confirmed as primary lung adenocarcinoma. Postoperative pneumothorax complication occurred in the third patient with right lung compression rate approximately 20%. ConclusionsThe application of CBCT, combined with VBN and the superimposed high frequency jet ventilator for respiratory control can potentially improve the accuracy and safety in the diagnosis of PPNs. Multi-center clinical trials are needed to verify its further clinical application.
ObjectiveTo evaluate the diagnostic value of endobronchial ultrasound technology in combination with LungPoint virtual navigation system for pulmonary peripheral nodules. MethodsRetrospective 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. ResultsThere 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. ConclusionsLungPoint 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.