Evaluation Of Pulmonary Nodules Using The Spyglass Direct Visualization System Combined With Radial Endobronchial Ultrasound: A Feasability Study

Background: Sampling of peripheral pulmonary nodules with radial endobronchial ultrasound (p-EBUS) increases diagnostic yield of bronchoscopy. However, diagnostic yield is influenced by numerous factors. Objective: We evaluated the use of SpyGlass, a one millimeter diameter optic fiber, to obtain images of the distal mucosa and of pulmonary lesions detected with p-EBUS to determine if visual aspect of the distal mucosa was predictive of diagnosis. Methods: We prospectively recruited subjects investigated for peripheral nodules. Bronchoscopy was performed and p-EBUS was used to locate the lesion through a guide sheath. The Spyglass fiber was introduced in the sheath to obtain images of the distal bronchial mucosa. Tissue sampling was subsequently done. Results: Fifteen patients were enrolled in the study. A final diagnosis of malignancy was confirmed in 80%. All lesions could be located using p-EBUS (100%). Diagnostic sensitivity for p-EBUS was 58.3%. Distal mucosa could be imaged with SpyGlass in 14/15 patients (93.3%). Mucosal appearance was described as abnormal in 7 out of the 15 subjects. Mean SpyGlass procedure time was 6.5 minutes. No direct complication was reported. Conclusion: Spyglass can be used in combination with p-EBUS to obtain images of the distal bronchial mucosa and peripheral pulmonary nodules. More patients will be needed to confirm whether mucosal appearance can be predictive of malignancy.

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Efficacy of Combined Endoscopic Lithotomy and Extracorporeal Shock Wave Lithotripsy, and Additional Electrohydraulic Lithotripsy Using the SpyGlass Direct Visualization System or X-Ray Guided EHL as Needed, for Pancreatic Lithiasis

BioMed Research International ◽

10.1155/2014/732781 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

Ken Ito ◽

Yoshinori Igarashi ◽

Naoki Okano ◽

Takahiko Mimura ◽

Yui Kishimoto ◽

...

Keyword(s):

Shock Wave ◽

Extracorporeal Shock Wave Lithotripsy ◽

Shock Wave Lithotripsy ◽

Direct Visualization ◽

Visualization System ◽

X Ray ◽

Electrohydraulic Lithotripsy ◽

Extracorporeal Shock Wave ◽

Pancreatic Lithiasis ◽

Spyglass Direct Visualization System

Introduction. To evaluate the efficacy of combined endoscopic lithotomy and extracorporeal shock wave lithotripsy (ESWL), and additional electrohydraulic lithotripsy (EHL) as needed, for the treatment of pancreatic duct stones, we retrospectively evaluated 98 patients with chronic pancreatitis and pancreatic lithiasis.Methods. For the management of main pancreatic duct (MPD) stones in 98 patients, we performed combined endoscopic treatment (ET)/ESWL therapy as the first treatment option. When combined ET/ESWL was unsuccessful, EHL with the SpyGlass Direct Visualization system or X-ray guided EHL was performed. Outpatient ESWL was reserved as one of the final treatment options.Results. Fragmentation was successful in 80 (81.6%) patients as follows: combined ET/ESWL: 67 cases; SpyGlass EHL: 4 cases; X-ray guided EHL: 3 cases; and outpatient ESWL: 6 cases. Successful outcome was obtained by combined ET/ESWL in 67 of the 98 patients (74.5%), by EHL in 7 of 14 patients (7.1%), and by outpatient ESWL in 6 of 6 patients (6.1%). Negotiating the guidewire through a severe MPD stricture was significantly associated with a higher rate of stone fragmentation (P=0.0003).Conclusions. In cases where combined ET/ESWL was not successful for stone clearance, EHL using the SpyGlass system or X-ray guided EHL was effective in cases where the guidewire could be negotiated through the MPD stricture and it increased the fragmentation rate.

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Assessment of SPYGLASS Direct Visualization System for Cholangioscopy and Pancreatoscopy in 102 Consecutive Patients

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2009.03.727 ◽

2009 ◽

Vol 69 (5) ◽

pp. AB273 ◽

Cited By ~ 3

Author(s):

Jayde Kurland ◽

Nuri Ozden ◽

Suck-Ho Lee ◽

Rishi Pawa ◽

Mandeep Sawhney ◽

...

Keyword(s):

Direct Visualization ◽

Visualization System ◽

Spyglass Direct Visualization System

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1365 A Rare Case of Neuroendocrine Tumor Originating in Liver Diagnosed by ERCP Using a Spyglass Direct Visualization System

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000594988.48661.df ◽

2019 ◽

Vol 114 (1) ◽

pp. S754-S755

Author(s):

Dong Joo Seo ◽

Sarav Daid ◽

Yashvin Onkarappa Mangala ◽

Amer Malik

Keyword(s):

Neuroendocrine Tumor ◽

Rare Case ◽

Direct Visualization ◽

Visualization System ◽

Spyglass Direct Visualization System

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Interobserver Agreement for Single Operator Choledochoscopy Imaging: Can We Do Better?

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2014/730731 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 14

Author(s):

Amrita Sethi ◽

Theodore Doukides ◽

Divyesh V. Sejpal ◽

Douglas K. Pleskow ◽

Adam Slivka ◽

...

Keyword(s):

Interobserver Agreement ◽

Final Diagnosis ◽

Boston Scientific ◽

Direct Visualization ◽

Visualization System ◽

Video Clips ◽

Average Accuracy ◽

Single Operator ◽

Biliary Pathology ◽

Spyglass Direct Visualization System

Background. The SpyGlass Direct Visualization System (Boston Scientific, Natick, MA) is routinely used during single operator choledochoscopy (SOC) to identify biliary lesions or strictures with a diagnostic accuracy up to 88%. The objective of this study was to determine the interobserver agreement (IOA) of modified scoring criteria for diagnosing biliary lesions/strictures. Methods. 27 SPY SOC video clips were reviewed and scored by 9 interventional endoscopists based on published criteria that included the presence and severity of surface structure, vasculature visualization, lesions, and findings. Results. Overall IOA was “slight” for all variables. The K statistics are as follows: surface (K=0.12, SE = 0.02); vessels (K=0.14, SE = 0.02); lesions (K=0.11, SE = 0.02); findings (K=0.08, SE = 0.03); and final diagnosis (K=0.08, SE = 0.02). The IOA for “findings” and “final diagnosis” was also only “slight.” The final diagnosis was malignant (11), benign (11), and indeterminate (5). Conclusion. IOA using the modified criteria of SOC images was slight to almost poor. The average accuracy was less than 50%. These findings reaffirm that imaging criteria for benign and malignant biliary pathology need to be formally established and validated.

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