@Article{MartaDiez-Ferrer2019,
author="Marta Diez-Ferrer
and Arturo Morales
and Rosa Lopez Lisbona
and Noelia Cubero
and Cristian Tebe
and Susana Padrones
and Samantha Aso
and Jordi Dorca
and Debora Gil
and Antoni Rosell",
title="Ultrathin Bronchoscopy with and without Virtual Bronchoscopic Navigation: Influence of Segmentation on Diagnostic Yield",
journal="Respiration",
year="2019",
volume="97",
number="3",
pages="252--258",
optkeywords="Lung cancer",
optkeywords="Peripheral lung lesion",
optkeywords="Diagnosis",
optkeywords="Bronchoscopy",
optkeywords="Ultrathin bronchoscopy",
optkeywords="Virtual bronchoscopic navigation",
abstract="Background: Bronchoscopy is a safe technique for diagnosing peripheral pulmonary lesions (PPLs), and virtual bronchoscopic navigation (VBN) helps guide the bronchoscope to PPLs. Objectives: We aimed to compare the diagnostic yield of VBN-guided and unguided ultrathin bronchoscopy (UTB) and explore clinical and technical factors associated with better results. We developed a diagnostic algorithm for deciding whether to use VBN to reach PPLs or choose an alternative diagnostic approach. Methods: We compared diagnostic yield between VBN-UTB (prospective cases) and unguided UTB (historical controls) and analyzed the VBN-UTB subgroup to identify clinical and technical variables that could predict the success of VBN-UTB. Results: Fifty-five cases and 110 controls were included. The overall diagnostic yield did not differ between the VBN-guided and unguided arms (47 and 40\%, respectively; p = 0.354). Although the yield was slightly higher for PPLs <=20 mm in the VBN-UTB arm, the difference was not significant (p = 0.069). No other clinical characteristics were associated with a higher yield in a subgroup analysis, but an 85\% diagnostic yield was observed when segmentation was optimal and the PPL was endobronchial (vs. 30\% when segmentation was suboptimal and 20\% when segmentation was optimal but the PPL was extrabronchial). Conclusions: VBN-guided UTB is not superior to unguided UTB. A greater impact of VBN-guided over unguided UTB is highly dependent on both segmentation quality and an endobronchial location of the PPL. Segmentation quality should be considered before starting a procedure, when an alternative technique that may improve yield can be chosen, saving time and resources.",
optnote="IAM; 600.145; 600.139",
optnote="exported from refbase (http://refbase.cvc.uab.es/show.php?record=3134), last updated on Mon, 30 Nov 2020 12:10:16 +0100",
opturl="https://doi.org/10.1159/000493270"
}