scholarly journals Minimally invasive interventions for pulmonary nodules biopsy. Systematic review protocol.

2020 ◽  
Author(s):  
Andre Miotto ◽  
João Aléssio Juliano Perfeito ◽  
Rafael Pacheco Leite ◽  
Carolina de Oliveira Cruz Latorraca ◽  
Rachel Riera
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Randomized Clinical Trials ◽  
Diagnostic Yield ◽  
Lung Nodule ◽  
Pulmonary Nodules ◽  
Percutaneous Biopsy ◽  
Transbronchial Biopsy ◽  
Endobronchial Ultrasound ◽  
Electromagnetic Navigation

Abstract Background Lung cancer is the most common malignancy, causing more than 1.6 million deaths annually worldwide, including approximately 26.500 deaths in Brazil alone in 2015. The diagnosis of pulmonary nodules remains a challenge. Imaging tests are important for diagnostic suspicion and for estimating risk, but biopsy is necessary to confirm malignancy. Minimally invasive methods currently used include tomography-guided percutaneous biopsy (CTGB) and bronchoscopy transbronchial biopsy. The method of choice should have the best accuracy with the lowest possible complication rate. This systematic review was designed to map, critically evaluate and compare the effects (benefits and risks) of all lung nodule biopsy techniques. Methods We will conduct a systematic review accordantly to the Cochrane Handbook for Systematic Reviews of Interventions recommendations. Discussion This study aims to compare the diagnostic yield and the safety of different techniques used for pulmonary nodule biopsies. We will include randomized clinical trials comparing tomography-guided percutaneous biopsy, non-guided transbronchial biopsy, fluoroscopy-guided transbronchial biopsy, transbronchial biopsy guided by endobronchial ultrasound with radial probe and transbronchial biopsy guided by electromagnetic navigation. This study was approved by the research ethics committee of Universidade Federal de São Paulo (UNIFESP) with the number 1344040918. The results of the completed protocol will be presented at any appropriate conference by the authors.Systematic review registration The protocol for this review was prospectively registered in PROSPERO database (C RD42018092367).

scholarly journals Minimally invasive interventions for pulmonary nodule biopsy: A systematic review protocol.

2020 ◽  
Author(s):  
Andre Miotto ◽  
João Aléssio Juliano Perfeito ◽  
Rafael Pacheco Leite ◽  
Carolina de Oliveira Cruz Latorraca ◽  
Rachel Riera
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Minimally Invasive ◽  
Pulmonary Nodule ◽  
Randomized Clinical Trials ◽  
Lung Nodule ◽  
Percutaneous Biopsy ◽  
Transbronchial Biopsy ◽  
Endobronchial Ultrasound ◽  
Electromagnetic Navigation

Abstract Background Lung cancer is the leading cause of cancer-related deaths worldwide, causing more than 1.6 million deaths annually, including 26,500 deaths in Brazil in 2015. The diagnosis of lung cancer in the early stages remains a challenge. Imaging tests are important for diagnostic suspicion and risk evaluation, but biopsy is needed to confirm malignancy. Minimally invasive methods for biopsy used include computed tomography-guided percutaneous biopsy (CTGB) and bronchoscopy transbronchial biopsy. The method of choice should have the best accuracy and the lowest complication rate. This systematic review is designed to map, critically evaluate and compare the effects (benefits and risks) of all lung nodule biopsy techniques.Methods We will conduct a systematic review according to the Cochrane Handbook for Systematic Reviews of Interventions recommendations.Discussion This study aims to compare the diagnostic yield and the safety of different techniques used for pulmonary nodule biopsy. We will include randomized clinical trials comparing tomography-guided percutaneous biopsy, nonguided transbronchial biopsy, fluoroscopy-guided transbronchial biopsy, transbronchial biopsy guided by endobronchial ultrasound with a radial probe and transbronchial biopsy guided by electromagnetic navigation. This study was approved by the research ethics committee of Universidade Federal de São Paulo (UNIFESP) (number 1344040918). The results of the completed protocol will be presented at any appropriate conference by the authors.Systematic review registration The protocol for this review was prospectively registered in the PROSPERO database (CRD42018092367).

scholarly journals Robotic Bronchoscopy for the Diagnosis of Peripheral Lung Nodules: a Review

2021 ◽  
Author(s):  
Jonathan Puchalski
Keyword(s):  
Safety Profile ◽  
Randomized Clinical Trials ◽  
Lung Nodule ◽  
Pulmonary Nodules ◽  
Endobronchial Ultrasound ◽  
Virtual Bronchoscopy ◽  
Electromagnetic Navigation ◽  
Technological Advances ◽  
Favorable Safety ◽  
Robotic Bronchoscopy

Abstract Purpose of Review Conventional bronchoscopy has limitations based on an inability to accurately reach and reliably diagnose peripheral lesions with many studies having a yield of less than 50%. Although newer technology such as virtual bronchoscopy, use of smaller bronchoscopes, peripheral endobronchial ultrasound, and electromagnetic navigation may have some improvements and a better safety profile, oftentimes transthoracic or surgical biopsies are required to establish a diagnosis and rule out malignancy. The purpose of this review is to highlight the potential benefits of robotic bronchoscopy, the latest in technological advances for this very common medical issue. Recent Findings Recently published early studies suggest the yield of robotic bronchoscopy may surpass 90%. Studies performed in cadavers and humans suggest robotic bronchoscopic platforms are better than currently existing bronchoscopic modalities for lung nodule diagnosis and have a favorable safety profile. Summary Although additional multi-center randomized clinical trials are needed, robotic bronchoscopy appears poised to supplement current bronchoscopic techniques for establishing a diagnosis of pulmonary nodules.

scholarly journals Comparing Multimodality-Guided Transbronchial Lung Biopsy in Small Peripheral Pulmonary Nodules by Thin Bronchoscopy and Electromagnetic Navigation Bronchoscopy: A Randomised Trial

2020 ◽  
Author(s):  
Supparerk Disayabutr ◽  
Anuttra Ratnarathon ◽  
Jamsak Tscheikuna
Keyword(s):  
Multivariate Analysis ◽  
Pulmonary Nodule ◽  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Randomised Trial ◽  
Pulmonary Nodules ◽  
Endobronchial Ultrasound ◽  
Electromagnetic Navigation ◽  
Significant Difference ◽  
Mean Size

Abstract BackgroundVarious modalities of guided bronchoscopy have been developed to improve the diagnostic yield of peripheral pulmonary nodule (PPN). The present study compared the diagnostic yield between thin bronchoscopy (TB) and electromagnetic navigation bronchoscopy (ENB) in diagnosis of PPN.MethodsThe patients with PPN less than or equal to 30 mm were randomly assigned into 2 groups, 4-mm thin bronchoscope (TB group) and 5.9-mm conventional bronchoscope with using ENB (the superDimension) system (ENB group). In both groups, we used radial probe endobronchial ultrasound (R-EBUS) and fluoroscopy to guide transbronchial lung biopsy.ResultsThe total of 49 patients were enrolled and randomized into TB group (n=24) and ENB group (n=25). Mean size of PPN was 22 mm. There was no difference in nodule size, location of nodule, the presence of CT bronchus sign and EBUS visualization between groups. The diagnostic yields were 73.9% and 66.7% in TB group and ENB group, respectively. There was no statistically significant difference in the diagnostic yield between two groups and the non-inferiority of the TB group could not be confirmed. Multivariate analysis showed that the diagnostic yield was significantly higher if there is CT bronchus sign (odd ratio 48.82, p = 0.031) and the bronchoscope can reach more airway depth (odd ratio 6.21, p = 0.023). The overall complication was 2% which is pneumothorax in one patient in the TB group.ConclusionsThe thin bronchoscopy has a comparable diagnostic yield as electromagnetic bronchoscopy in diagnosis of peripheral pulmonary nodule without serious complication.Trial registrationTCTR, TCTR20200224003. Registered 24 February 2020 - Retrospectively registered, https://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=5834.

scholarly journals Diagnostic Yield and Safety of Electromagnetic Navigation Bronchoscopy for Lung Nodules: A Systematic Review and Meta-Analysis

Respiration ◽  
2014 ◽  
Vol 87 (2) ◽  
pp. 165-176 ◽  
Author(s):  
Gregoire Gex ◽  
Jacques A. Pralong ◽  
Christophe Combescure ◽  
Luis Seijo ◽  
Thierry Rochat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Lung Nodules ◽  
Electromagnetic Navigation

scholarly journals Cone-Beam Computed Tomography-Derived Augmented Fluoroscopy Improves the Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Biopsy for Peripheral Pulmonary Lesions

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 41
Author(s):  
Ching-Kai Lin ◽  
Hung-Jen Fan ◽  
Zong-Han Yao ◽  
Yen-Ting Lin ◽  
Yueh-Feng Wen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Success Rate ◽  
Diagnostic Yield ◽  
Study Groups ◽  
Transbronchial Biopsy ◽  
Endobronchial Ultrasound ◽  
Cone Beam ◽  
Ultrasound Guided ◽  
Pulmonary Lesions ◽  
Peripheral Pulmonary Lesions

Background: Endobronchial ultrasound-guided transbronchial biopsy (EBUS-TBB) is used for the diagnosis of peripheral pulmonary lesions (PPLs), but the diagnostic yield is not adequate. Cone-beam computed tomography-derived augmented fluoroscopy (CBCT-AF) can be utilized to assess the location of PPLs and biopsy devices, and has the potential to improve the diagnostic accuracy of bronchoscopic techniques. The purpose of this study was to verify the contribution of CBCT-AF to EBUS-TBB. Methods: Patients who underwent EBUS-TBB for diagnosis of PPLs were enrolled. The navigation success rate and diagnostic yield were used to evaluate the effectiveness of CBCT-AF in EBUS-TBB. Results: In this study, 236 patients who underwent EBUS-TBB for PPL diagnosis were enrolled. One hundred fifteen patients were in CBCT-AF group and 121 were in non-AF group. The navigation success rate was significantly higher in the CBCT-AF group (96.5% vs. 86.8%, p = 0.006). The diagnostic yield was even better in the CBCT-AF group when the target lesion was small in size (68.8% vs. 0%, p = 0.026 for lesions ≤10 mm and 77.5% vs. 46.4%, p = 0.016 for lesions 10–20 mm, respectively). The diagnostic yield of the two study groups became similar when the procedures with a failure of navigation were excluded. The procedure-related complication rate was similar between the two study groups. Conclusion: CBCT-AF is safe, and effectively enhances the navigation success rate, thereby increasing the diagnostic yield of EBUS-TBB for PPLs.

Flip flop fungus sign: an FDG PET sign of benign pulmonary nodules

2020 ◽  
Vol 13 (11) ◽  
pp. e236231
Author(s):  
Valeri Kraskovsky ◽  
Brianne MacKenzie ◽  
Ayesha Arshad ◽  
Martin Jeffery Mador
Keyword(s):  
Fdg Pet ◽  
Histoplasma Capsulatum ◽  
Clinical Course ◽  
Lung Nodule ◽  
Pulmonary Nodules ◽  
Lymph Node Biopsy ◽  
Endobronchial Ultrasound ◽  
Flip Flop ◽  
Node Biopsy ◽  
Mediastinal Adenopathy

A 71-year-old man was referred to pulmonary clinic for incidental findings of hypermetabolic lung nodule and mediastinal adenopathy on CT FDG PET performed for evaluation of cough. The patient underwent bronchoscopy with endobronchial ultrasound that was non-diagnostic. The patient was subsequently sent for video-assisted thoracoscopic lymph node biopsy notable for confluent caseating granulomas due to chronic infection by Histoplasma capsulatum. Review of previous PDG PET was notable for the flip flop fungus sign—a PDG PET finding that could have altered the patients’ clinical course by potentially avoiding the need for invasive surgical tissue diagnosis.

scholarly journals Minimally Invasive Methods for Staging in Lung Cancer: Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Gonzalo Labarca ◽  
Carlos Aravena ◽  
Francisco Ortega ◽  
Alex Arenas ◽  
Adnan Majid ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Endobronchial Ultrasound ◽  
Safe Procedure ◽  
Mediastinal Staging ◽  
Prospective Trials ◽  
Sensitivity Specificity ◽  
Search Quality ◽  
Quality Assessments

Introduction. Endobronchial ultrasound (EBUS) is a procedure that provides access to the mediastinal staging; however, EBUS cannot be used to stage all of the nodes in the mediastinum. In these cases, endoscopic ultrasound (EUS) is used for complete staging.Objective. To provide a synthesis of the evidence on the diagnostic performance of EBUS + EUS in patients undergoing mediastinal staging.Methods. Systematic review and meta-analysis to evaluate the diagnostic yield of EBUS + EUS compared with surgical staging. Two researchers performed the literature search, quality assessments, data extractions, and analyses. We produced a meta-analysis including sensitivity, specificity, and likelihood ratio analysis.Results. Twelve primary studies (1515 patients) were included; two were randomized controlled trials (RCTs) and ten were prospective trials. The pooled sensitivity for combined EBUS + EUS was 87% (CI 84–89%) and the specificity was 99% (CI 98–100%). For EBUS + EUS performed with a single bronchoscope group, the sensitivity improved to 88% (CI 83.1–91.4%) and specificity improved to 100% (CI 99-100%).Conclusion. EBUS + EUS is a highly accurate and safe procedure. The combined procedure should be considered in selected patients with lymphadenopathy noted at stations that are not traditionally accessible with conventional EBUS.

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