Yapay Zeka Hızlı Bakış & Çıkarımlar
AI InsightThe presence of bronchus sign;location of the lesion; and the characteristics, size, and stage of cancer did not have any impact on the diagnostic yield.CONCLUSION: Virtual bronchoscopy-guided ultrathin bronchoscopy with bronchial brushing is safe and has a diagnostic yield comparable to other described techniques for evaluating peripheral pulmonary nodules.
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Özet
OBJECTIVES: The use of an ultrathin bronchoscope (UB) to diagnose peripheral pulmonary lesions is described. A virtual bronchoscopicnavigation system was used to direct the ultrathin scope to the nodule. One of the constraints of this technique was the inability to confirm the target lesion position during biopsy by using a conventional linear endobronchial ultrasound probe, since the probe does not fitinto a 1.2 mm working channel of this bronchoscope. The aim of the study was to review our institutional experience with the use of aUB for sampling peripheral pulmonary lesions using the transbronchial brush guided by virtual bronchoscopy. We describe a techniquewherein we attempt to brush all the visible bronchial sub-segments once the bronchoscope has reached close to the nodule.MATERIALS AND METHODS: In total, 52 patients underwent the procedure between 2010 and 2017. A multiplanar computed tomography (CT) scan of the chest was obtained and subsequently uploaded to the Lung Point Virtual bronchoscopy navigation software. TheUB was parked close to the lesion. All visible airway branches were then brushed using a protected bronchial brush. The data wereretrospectively abstracted from the electronic medical records using standardized forms.RESULTS: A total of 52 lesions (40 solid, 8 part-solid, 3 cavitary, and 1 ground-glass) were sampled using a transbronchial brush (median,2; range, 1-8). Twenty-four lesions were under 2 cm in size. The overall success rates were 67.3%. The average diameter of nodules was2.7±1.01 cm; 65% lesions were in the outer-third of the lungs. The cancer-specific sensitivity was 72.5%. The presence of bronchus sign;location of the lesion; and the characteristics, size, and stage of cancer did not have any impact on the diagnostic yield.CONCLUSION: Virtual bronchoscopy-guided ultrathin bronchoscopy with bronchial brushing is safe and has a diagnostic yield comparable to other described techniques for evaluating peripheral pulmonary nodules.