%0 Journal Article
%T Ultrathin Bronchoscopy with and without Virtual Bronchoscopic Navigation: Influence of Segmentation on Diagnostic Yield
%A Marta Diez-Ferrer
%A Arturo Morales
%A Rosa Lopez Lisbona
%A Noelia Cubero
%A Cristian Tebe
%A Susana Padrones
%A Samantha Aso
%A Jordi Dorca
%A Debora Gil
%A Antoni Rosell
%J Respiration
%D 2019
%V 97
%N 3
%F Marta Diez-Ferrer2019
%O IAM; 600.145; 600.139
%O exported from refbase (http://refbase.cvc.uab.es/show.php?record=3134), last updated on Mon, 30 Nov 2020 12:10:16 +0100
%X 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.
%K Lung cancer
%K Peripheral lung lesion
%K Diagnosis
%K Bronchoscopy
%K Ultrathin bronchoscopy
%K Virtual bronchoscopic navigation
%U https://doi.org/10.1159/000493270
%P 252-258