Document Detail


CT-guided transbronchial biopsy using an ultrathin bronchoscope with virtual bronchoscopic navigation.
MedLine Citation:
PMID:  15006979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVES: We evaluated the feasibility, safety, and efficacy of CT-guided transbronchial biopsy (TBB) using an ultrathin bronchoscope with navigation by virtual bronchoscopy (VB) for small peripheral pulmonary lesions of < 20 mm in diameter. DESIGN: A pilot study. SETTING: A national university hospital. PATIENTS: We performed CT-guided TBB after VB navigation for 25 patients with 26 small peripheral pulmonary lesions (average diameter, 13.2 mm) between June 1, 2001, and October 31, 2002. Of the 26 lesions, 10 were in the right upper lobe, 2 were in the right middle lobe, 6 were in the right lower lobe, and 8 were in the left upper lobe. Nineteen lesions were not detected on chest radiographs. INTERVENTIONS: VB images were reconstructed from helical CT scans. CT-guided TBB was performed using an ultrathin bronchoscope after studying the VB image. RESULTS: CT-guided TBB was performed safely without any complications for all patients. The bronchi seen under VB imaging were highly consistent with the actual bronchi confirmed using an ultrathin bronchoscope. The ultrathin bronchoscope was inserted between the fifth and eighth generation bronchi. The average durations of the initial scan, the first biopsy, and the total examination were 5.46, 12.96, and 29.27 min, respectively. Seventeen lesions (65.4%) were diagnosed from pathology examinations (primary lung cancers, 13; atypical adenomatous hyperplasia, 1; metastatic cancer, 1; sarcoidosis, 1; and nontuberculous mycobacteriosis, 1). Diagnoses were not obtained for the remaining lesions due to an insufficient number of specimens (six specimens) or to the inability to reach the lesions even using the ultrathin bronchoscope (three specimens). CONCLUSIONS: In summary, CT-guided TBB using an ultrathin bronchoscope with VB navigation was safely performed and was effective for diagnosing small peripheral pulmonary lesions.
Authors:
Naofumi Shinagawa; Koichi Yamazaki; Yuya Onodera; Kazuo Miyasaka; Eiki Kikuchi; Hirotoshi Dosaka-Akita; Masaharu Nishimura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  125     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-09     Completed Date:  2004-04-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1138-43     Citation Subset:  AIM; IM    
Affiliation:
First Department of Medicine, School of Medicine, Hokkaido University, Sapporo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Biopsy, Needle / methods*
Bronchoscopes
Bronchoscopy*
Female
Humans
Lung / pathology*,  radiography
Male
Middle Aged
Radiography, Interventional*
Tomography, X-Ray Computed*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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