- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05383105
Virtual Bronchoscopic Navigation to Increase Diagnostic Yield in Patients With Pulmonary Nodules (NAVIGATOR)
Background Transthoracic computed tomography (CT)-guided procedures are the current gold Standard for obtaining diagnostic biopsies of solitary pulmonary nodules (SPN) in the peripheral lung. Novel endobronchial techniques, such as electromagnetic navigation bronchoscopy (ENB) or Virtual bronchoscopic navigation (VBN) are considered safer to approach SPNs.
The newest technique combines VBN with calculating the access to a SPN via a transparenchymal route. In contrast to the gold Standard transthoracic approach, also small lesions, and lesions which cannot be reached transthoracicaliy, located in the innertwo thirdsof the lung can be approached.
Main research question To assess diagnostic yield of the novel Standard of care 'Virtual bronchoscopy navigation" procedure.
Design (including population, confounders/outcomes) A single centre, prospective, observational study of patients undergoing the novel Standard of care Virtual bronchoscopy navigation procedure to assess a pulmonary nodule. Clinical data of at least 100 consecutive patients will be collected.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background Transthoracic computed tomography (CT)-guided procedures are the current gold Standard for obtaining diagnostic biopsies of solitary pulmonary nodules (SPN) in the peripheral lung. Despite its accuracy and diagnostic yield, this technique is associated with an increased risk of complications, Pneumothorax and severe bleeding are the most frequent complications occurring in up to 27% of cases each.
Novel endobronchial techniques, such as electromagnetic navigation bronchoscopy (ENB) or Virtual bronchoscopic navigation (VBN) are considered safer to approach SPNs. The overall rate of pneumothorax after ENB is 4.3%, and bleeding occurs in only 2.8% of cases. The combination of techniques led to an overall increase of the diagnostic yield.
The newest technique combines VBN with calculating the access to a SPN via a transparenchymal route. In contrast to the gold Standard transthoracic approach, also small lesions, and lesions which cannot be reached transthoracicaliy, located in the innertwo thirdsof the lung can be approached. Detailed clinical data, like the correlation of the diagnostic yield to the specific location of the pulmonary nodule, however, is lacking. In view of the expected lung cancer screening program leading to increasing numbers of especially small pulmonary nodules, this data, however, is considered useful to help to select patients forthe right diagnostic procedure.
Main research question To assess diagnostic yield of the novel Standard of care 'Virtual bronchoscopy navigation" procedure.
Design (including population, confounders/outcomes) A single centre, prospective, observational study of patients undergoing the novel Standard of care Virtual bronchoscopy navigation procedure to assess a pulmonary nodule. Clinical data of at least 100 consecutive patients will be collected.
Expected results With the VBN procedure a histologie diagnosis of a SPN can be obtained safely with high diagnostic yield. Correlation to detailed clinical data is expected to help selecting patients for this procedure in the future.
In the future add on technique such as confocal laser endomicroscopy and fluorescence molecular endoscopy might further improve identification of the lesion during the procedure. Ultimately, we expect that development of this technique will pave the way to a one-stop-shop approach with rapid on-site evaluation followed by local treatment (e.g. microwave ablation) of the malignant pulmonary nodule.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Dirk-Jan Slebos, MD PhD
- Phone Number: +31503612357
- Email: d.j.slebos@umcg.nl
Study Contact Backup
- Name: Birgitta Hiddinga, MD
- Phone Number: +31503612357
- Email: b.i.hiddinga@umcg.nl
Study Locations
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Groningen, Netherlands, 9700 RB
- Recruiting
- UMCG Groningen
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Contact:
- Birgitta Hiddinga, MD
- Phone Number: +31503612357
- Email: b.i.hiddinga@umcg.nl
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- age >18
- pulmonary nodule(s) suspicious for malignancy or metastases of a known primary tumour
- a distinct nodule with a diameter of >6 mm in its largest dimension
- nodule located in the parenchymal tissue >1 cm from the pleura and bronchoscopically accessible through a point of entry
- willing to give informed consent to the procedure.
Exclusion Criteria:
- any contraindication to undergo bronchoscopy
- contraindication for general anaesthesia
- inability to stop anticoagulants or antiplatelets agents according to the UMCG protocol
- childbearing or breastfeeding women
- moderate to seyere pulmonary fibrosis
- severe emphysema with bullae > 5 cm m the vicinity of the target nodule or tunnel.
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Successful diagnostic procedure
Time Frame: During procedure
|
Number of procedures with success to access the solitary pulmonary nodule
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During procedure
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Collaborators and Investigators
Investigators
- Principal Investigator: Dirk-Jan Slebos, MD PhD, UMCG Groningen, The Netherlands
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 202100352
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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