Diagnostic Yield of Electromagnetic Navigation Bronchoscopy Using a Curved-tip Catheter to Aid in the Diagnosis of Pulmonary Lesions

Sumit Mukherjee, Michael Chacey, Sumit Mukherjee, Michael Chacey

Abstract

Background: Electromagnetic navigation bronchoscopy (ENB) may aid in the diagnosis of solitary pulmonary lesions with a lower complication rate than conventional diagnostic modalities. A curved-tip catheter is now available for use with ENB; however, the diagnostic yield of this device has not been previously reported.

Methods: A single-center, single-operator retrospective chart review was performed on patients who underwent ENB for the diagnosis of pulmonary lesions. A curved-tip catheter was used in all procedures; angle options were chosen depending on lesion location. After navigation to the target lesion, fine-needle aspiration, brushings, biopsies, and bronchoalveolar lavage were performed in all patients. Correct localization was confirmed with fluoroscopy.

Results: Thirty-one consecutive patients underwent ENB between February and October 2014. The mean lesion size was 1.8 cm (range, 0.4 to 4.0 cm) and 35% were in the right upper lobe. The probe tip was navigated to the target lesion in all cases. A diagnosis was obtained in 30/31 patients (96.8%). Twenty-two (71%) had a definitive histologic diagnosis of malignancy. One case was nondiagnostic requiring a repeat fine-needle aspiration. The remaining 8 nonmalignant cases were followed radiologically and demonstrated no progression of lesion size through at least 1 year. Fiducials were placed in 48% of cases. There were 2 pneumothoraces (6.5%), one of which required chest tube placement (3.2%).

Conclusions: This study suggests that the curved-tip catheter is a useful modality for diagnosing peripheral pulmonary lesions with ENB. The diagnostic yield of ENB using this catheter was superior to that reported in other studies utilizing straight catheters.

Conflict of interest statement

Disclosure: M.C. has a publication support agreement with Medtronic for the completion of this work. There is no conflict of interest or other disclosures for the remaining authors.

Figures

FIGURE 1
FIGURE 1
Curved-tip catheter in 45 degrees (A), 90 degrees (B), and 180 degrees (C) configurations. All rights reserved. Used with the permission of Medtronic. Copyright 2016 Medtronic.

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