Innovative bronchoscopic diagnostic techniques: endobronchial ultrasound and electromagnetic navigation.
OBJECTIVE
Bronchoscopy is a minimally invasive method for diagnosing lung diseases, but the technique has some limitations. In case of parabronchial lesions, the view is limited to the inner surface. Therefore, endobronchial ultrasound systems were developed. For obtaining biopsies of peripheral lung lesions, a new real-time guidance system shows promising results. In this review the authors assess the most important and interesting articles in both fields.


RESULTS
In a trial it was shown that with the help of endobronchial ultrasound the diagnosing and staging of lung cancer and other pathologies could be improved. It is a safe technique and it has proved extremely useful during diagnostic and interventional procedures. With the navigation conclusive, biopsies were obtained in nearly 70% of the patients without any severe side effects.


CONCLUSIONS
Endobronchial ultrasound proved to be useful in high-resolution imaging of the multilayer structures of the bronchial wall and the adjacent mediastinal structures at a distance of as much as 4 cm. Lymph nodes could be easily localized for transbronchial needle aspiration. In many instances it was superior for staging lung cancer and other pathologies. Real-time electromagnetic-guided bronchoscopy, coupled with computed tomography is a feasible and safe method for obtaining biopsies from peripheral lung lesions.
Herth
Felix J F
FJ
Department of Pneumology and Critical Care Medicine, Thoraxklinik University of Heidelberg, Germany. Felix.Herth@throaxklinik-heidelberg.de
Ernst
Armin
A
D001999:Bronchoscopy / Q000379:methods*; D055590:Electromagnetic Phenomena; D019160:Endosonography; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008175:Lung Neoplasms / Q000175:diagnosis*