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Electromagnetic navigation bronchoscopy versus virtual bronchoscopy navigation for improving the diagnosis of peripheral lung lesions: analysis of the predictors of successful diagnosis

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Abstract

Purpose

To investigate if electromagnetic navigation bronchoscopy (ENB) improves the diagnostic yield for peripheral lung lesions from that achieved by virtual bronchoscopy navigation (VBN).

Methods

This retrospective study compared the results of 100 ENB-transbronchial lung biopsies (TBLBs) with those of 50 VBN-TBLBs at a single institution.

Results

ENB improved the diagnostic yield significantly compared with VBN (64.0% for 19.4 ± 9.0 mm tumors vs. 46.0% for 27.6 ± 8.9 mm tumors; p < 0.0001). Irrespective of the bronchus sign, ENB was more favorable than VBN, with 81.0% (47/58) achieved by ENB vs. 60.0% (21/35) achieved by VBN in the presence of the positive bronchus sign (p = 0.0283), and 40.5% (17/42) achieved by ENB vs. 13.3% (2/15) achieved by VBN in the absence of the bronchus sign (p = 0.0431). Univariate analysis identified tumor size (p = 0.0048), amount of intravenous sedation (p = 0.0182), registration time (p = 0.0111), minimum distance to target (p = 0.0244), and the bronchus sign (p < 0.0001) as factors that affected the yield significantly for ENB. Multivariate analysis identified the bronchus sign (odds ratio 6.74; 95% CI 1.84–24.7) and the registration time (OR 1.01; 95% CI 1.00–1.02) as significant factors.

Conclusions

Despite the bronchus sign being a significant factor, ENB improved the diagnostic yield of smaller lesions significantly, compared with VBN, regardless of the bronchus sign.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan

    Yojiro Yutaka, Masahide Isowa, Yoshitake Murata, Satona Tanaka, Yoshito Yamada, Akihito Ohsumi, Daisuke Nakajima, Masatsugu Hamaji, Toshi Menju & Hiroshi Date

  2. Department of Thoracic, Breast and Pediatric Surgery, Fukuoka University, Fukuoka, Japan

    Toshihiko Sato

  3. Department of Thoracic Surgery, Nagoya University Hospital, Nagoya, Japan

    Toyofumi Fengshi Chen-Yoshikawa

Authors
  1. Yojiro Yutaka
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  2. Toshihiko Sato
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  3. Masahide Isowa
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  4. Yoshitake Murata
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  5. Satona Tanaka
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  6. Yoshito Yamada
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  9. Masatsugu Hamaji
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  10. Toshi Menju
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  11. Toyofumi Fengshi Chen-Yoshikawa
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  12. Hiroshi Date
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Correspondence to Yojiro Yutaka.

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Yutaka, Y., Sato, T., Isowa, M. et al. Electromagnetic navigation bronchoscopy versus virtual bronchoscopy navigation for improving the diagnosis of peripheral lung lesions: analysis of the predictors of successful diagnosis. Surg Today 52, 923–930 (2022). https://doi.org/10.1007/s00595-021-02398-z

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