Added Value of a Robotic-assisted Bronchoscopy Platform in Cone Beam Computed Tomography-guided Bronchoscopy for the Diagnosis of Pulmonary Parenchymal Lesions.
Journal
Journal of bronchology & interventional pulmonology
ISSN: 1948-8270
Titre abrégé: J Bronchology Interv Pulmonol
Pays: United States
ID NLM: 101496866
Informations de publication
Date de publication:
01 Jul 2024
01 Jul 2024
Historique:
received:
21
12
2023
accepted:
18
04
2024
medline:
2
7
2024
pubmed:
2
7
2024
entrez:
2
7
2024
Statut:
epublish
Résumé
Cone beam computed tomography (CBCT)-guided bronchoscopic sampling of peripheral pulmonary lesions (PPLs) is associated with superior diagnostic outcomes. However, the added value of a robotic-assisted bronchoscopy platform in CBCT-guided diagnostic procedures is unknown. We performed a retrospective review of 100 consecutive PPLs sampled using conventional flexible bronchoscopy under CBCT guidance (FB-CBCT) and 100 consecutive PPLs sampled using an electromagnetic navigation-guided robotic-assisted bronchoscopy platform under CBCT guidance (RB-CBCT). Patient demographics, PPL features, procedural characteristics, and procedural outcomes were compared between the 2 cohorts. Patient and PPL characteristics were similar between the FB-CBCT and RB-CBCT cohorts, and there were no significant differences in diagnostic yield (88% vs. 90% for RB-CBCT, P=0.822) or incidence of complications between the 2 groups. As compared with FB-CBCT cases, RB-CBCT cases were significantly shorter (median 58 min vs. 92 min, P<0.0001) and used significantly less diagnostic radiation (median dose area product 5114 µGy•m2 vs. 8755 µGy•m2, P<0.0001). CBCT-guided bronchoscopy with or without a robotic-assisted bronchoscopy platform is a safe and effective method for sampling PPLs, although the integration of a robotic-assisted platform was associated with significantly shorter procedure times and significantly less radiation exposure.
Sections du résumé
BACKGROUND
BACKGROUND
Cone beam computed tomography (CBCT)-guided bronchoscopic sampling of peripheral pulmonary lesions (PPLs) is associated with superior diagnostic outcomes. However, the added value of a robotic-assisted bronchoscopy platform in CBCT-guided diagnostic procedures is unknown.
METHODS
METHODS
We performed a retrospective review of 100 consecutive PPLs sampled using conventional flexible bronchoscopy under CBCT guidance (FB-CBCT) and 100 consecutive PPLs sampled using an electromagnetic navigation-guided robotic-assisted bronchoscopy platform under CBCT guidance (RB-CBCT). Patient demographics, PPL features, procedural characteristics, and procedural outcomes were compared between the 2 cohorts.
RESULTS
RESULTS
Patient and PPL characteristics were similar between the FB-CBCT and RB-CBCT cohorts, and there were no significant differences in diagnostic yield (88% vs. 90% for RB-CBCT, P=0.822) or incidence of complications between the 2 groups. As compared with FB-CBCT cases, RB-CBCT cases were significantly shorter (median 58 min vs. 92 min, P<0.0001) and used significantly less diagnostic radiation (median dose area product 5114 µGy•m2 vs. 8755 µGy•m2, P<0.0001).
CONCLUSION
CONCLUSIONS
CBCT-guided bronchoscopy with or without a robotic-assisted bronchoscopy platform is a safe and effective method for sampling PPLs, although the integration of a robotic-assisted platform was associated with significantly shorter procedure times and significantly less radiation exposure.
Identifiants
pubmed: 38953732
doi: 10.1097/LBR.0000000000000971
pii: 01436970-202407010-00008
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Références
DiBardino DM, Yarmus LB, Semaan RW. Transthoracic needle biopsy of the lung. J Thorac Dis. 2015;7(suppl 4):S304–S316.
Folch EE, Bowling MR, Pritchett MA, et al. NAVIGATE 24-month results: Electromagnetic navigation bronchoscopy for pulmonary lesions at 37 centers in Europe and the United States. JTO. 2022;17:519–531.
Chandrika S, Yarmus L. Recent developments in advanced diagnostic bronchoscopy. Eur Respir Rev. 2020;29:190184.
Cicenia J, Bhadra K, Sethi S, et al. Augmented fluoroscopy: a new and novel navigation platform for peripheral bronchoscopy. J Bronchol Intervent Pulmonol. 2021;28:116–123.
Aboudara M, Roller L, Rickman O, et al. Improved diagnostic yield for lung nodules with digital tomosynthesis-corrected navigational bronchoscopy: initial experience with a novel adjunct. Respirology. 2020;25:206–213.
Pritchett MA, Bhadra K, Mattingley JS. Electromagnetic navigation bronchoscopy with tomosynthesis-based visualization and positional correction. J Bronchology Interv Pulmonol. 2021;28:10–20.
Avasarala SK, Roller L, Katsis J, et al. Sight unseen: diagnostic yield and safety outcomes of a novel multimodality navigation bronchoscopy platform with real-time target acquisition. RES. 2022;101:166–173.
Pertzov B, Gershman E, Izhakian S, et al. The lungvision navigational platform for peripheral lung nodule biopsy and the added value of cryobiopsy. Thorac Cancer. 2021;12:2007–2012.
Cheng GZ, Liu L, Nobari M, et al. Cone beam navigation bronchoscopy: the next frontier. J Thorac Dis. 2020;12:3272–3278.
Pritchett MA, Bhadra K, Calcutt M, et al. Virtual or reality: divergence between preprocedural computed tomography scans and lung anatomy during guided bronchoscopy. J Thorac Dis. 2020;12:1595–1611.
Setser R, Chintalapani G, Bhadra K, et al. Cone beam CT imaging for bronchoscopy: a technical review. J Thorac Dis. 2020;12:7416–7428.
Ost D, Pritchett M, Reisenauer J, et al. Prospective multicenter analysis of shape-sensing robotic-assisted bronchoscopy for the biopsy of pulmonary nodules: results from the PRECIsE study. Chest. 2021;160:A2531–A2533.
Chaddha U, Kovacs SP, Manley C, et al. Robot-assisted bronchoscopy for pulmonary lesion diagnosis: results from the initial multicenter experience. BMC Pulm Med. 2019;19:243.
Chen AC, Gillespie CT. Robotic endoscopic airway challenge: REACH Assessment. Ann Thorac Surg. 2018;106:293–297.
Abia-Trujillo D, Folch EE, Yu Lee-Mateus A, et al. Mobile cone-beam computed tomography complementing shape-sensing robotic-assisted bronchoscopy in the small pulmonary nodule sampling: a multicentre experience. Respirology. 2023;29:324–332.
Styrvoky K, Schwalk A, Pham D, et al. Radiation dose of cone beam CT combined with shape sensing robotic assisted bronchoscopy for the evaluation of pulmonary lesions: an observational single center study. J Thorac Dis. 2023;15:4836–4848.
Styrvoky K, Schwalk A, Pham D, et al. Shape-sensing robotic-assisted bronchoscopy with concurrent use of radial endobronchial ultrasound and cone beam computed tomography in the evaluation of pulmonary lesions. Lung. 2022;200:755–761.
Benn BS, Romero AO, Lum M, et al. Robotic-assisted navigation bronchoscopy as a paradigm shift in peripheral lung access. Lung. 2021;199:177–186.
Cumbo-Nacheli G, Velagapudi RK, Enter M, et al. Robotic-assisted Bronchoscopy and Cone-beam CT: a Retrospective Series. J Bronchology Interv Pulmonol. 2022;29:303–306.
Bhadra K, Setser RM, Condra W, et al. Lung navigation ventilation protocol to optimize biopsy of peripheral lung lesions. J Bronchology Interv Pulmonol. 2022;29:7–17.
Chen AC, Pastis NJ, Mahajan AK, et al. Robotic bronchoscopy for peripheral pulmonary lesions. Chest. 2021;159:845–852.
Gonzalez AV, Silvestri GA, Korevaar DA, et al. Assessment of Advanced Diagnostic Bronchoscopy Outcomes for Peripheral Lung Lesions: A Delphi Consensus Definition of Diagnostic Yield and Recommendations for Patient-centered Study Designs. An Official American Thoracic Society/American College of Chest Physicians Research Statement. Am J Respir Crit Care Med. 2024;209:634–646.
Team RC. R: a language and environment for statistical computing [Internet]. Vienna, Austria: R Foundation for Statistical Computing; 2024. http://www.R-project.org/
Bossuyt, Reitsma PM, Bruns DE JB, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ. 2015;351:h5527.
Kalchiem-Dekel O, Connolly JG, Lin I-H, et al. Shape-sensing robotic-assisted bronchoscopy in the diagnosis of pulmonary parenchymal lesions. Chest. 2022;161:572–582.
Simoff MJ, Pritchett MA, Reisenauer JS, et al. Shape-sensing robotic-assisted bronchoscopy for pulmonary nodules: initial multicenter experience using the IonTM Endoluminal System. BMC Pulm Med. 2021;21:322.
Vachani A, Zhou M, Ghosh S, et al. Complications after transthoracic needle biopsy of pulmonary nodules: a population-level retrospective cohort analysis. J Am Coll Radiol. 2022;19:1121–1129.
Ali EAA, Takizawa H, Kawakita N, et al. Transbronchial biopsy using an ultrathin bronchoscope guided by cone-beam computed tomography and virtual bronchoscopic navigation in the diagnosis of pulmonary nodules. RES. 2019;98:321–328.
Pritchett MA, Schampaert S, Groot JAH, et al. Cone-beam CT with augmented fluoroscopy combined with electromagnetic navigation bronchoscopy for biopsy of pulmonary nodules. J Bronchology Interv Pulmonol. 2018;25:274–282.
Hohenforst-Schmidt W, Zarogoulidis P, Vogl T, et al. Cone beam computertomography (CBCT) in interventional chest medicine-high feasibility for endobronchial realtime navigation. J Cancer. 2014;5:231–241.
Agrawal A, Hogarth DK, Murgu S. Robotic bronchoscopy for pulmonary lesions: a review of existing technologies and clinical data. J Thorac Dis. 2020;12:3279–3286.
Andreassi MG, Piccaluga E, Guagliumi G, et al. Occupational health risks in cardiac catheterization laboratory workers. Circ: Cardiovascular Interventions. 2016;9:e003273.
Rajaraman P, Doody MM, Yu CL, et al. Cancer risks in U.S. Radiologic Technologists working with fluoroscopically guided interventional procedures, 1994-2008. AJR Am J Roentgenol. 2016;206:1101–1108; quiz 1109.
Reeves RR, Ang L, Bahadorani J, et al. Invasive cardiologists are exposed to greater left sided cranial radiation: the BRAIN Study (Brain Radiation Exposure and Attenuation During Invasive Cardiology Procedures). JACC Cardiovasc Interv. 2015;8:1197–1206.
Heiden BT, Eaton DB Jr, Engelhardt KE, et al. Analysis of delayed surgical treatment and oncologic outcomes in clinical stage I Non–Small Cell Lung Cancer. JAMA Network Open. 2021;4:e2111613.
Bott MJ, Patel AP, Crabtree TD, et al. Pathologic upstaging in patients undergoing resection for Stage I non-small cell lung cancer: are there modifiable predictors? Ann Thorac Surg. 2015;100:2048–2053.
Ghosn M, Elsakka AS, Ridouani F, et al. Augmented fluoroscopy guided transbronchial pulmonary microwave ablation using a steerable sheath. Transl Lung Cancer Res. 2022;11:150–164.
Zeng C, Fu X, Yuan Z, et al. Application of electromagnetic navigation bronchoscopy-guided microwave ablation in multiple pulmonary nodules: a single-centre study. Eur J Cardiothorac Surg. 2022;62:ezac071.
Sabath BF, Casal RF. Bronchoscopic ablation of peripheral lung tumors. J Thorac Dis. 2019;11:2628–2638.
Verhoeven RLJ, Sterren W van der, Kong W, et al. Cone-beam CT and augmented fluoroscopy-guided navigation bronchoscopy: radiation exposure and diagnostic accuracy learning curves. J Bronchology Interv Pulmonol. 2021;28:262–271.