Transbronchial biopsy using endobronchial ultrasonography with a guide sheath and virtual bronchoscopic navigation.
OBJECTIVE
We evaluated the feasibility, safety, and efficacy of transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS) and virtual bronchoscopy (VB) navigation for small peripheral pulmonary lesions < or = 30 mm in diameter.


METHODS
Pilot study.


METHODS
A national university hospital.


METHODS
We performed TBB using EBUS-GS with VB navigation for 29 patients with 30 small peripheral pulmonary lesions (average diameter, 18.6 mm) between January 1, 2004, and August 31, 2004.


METHODS
VB images were reconstructed from helical CT data. TBB was then performed using EBUS-GS with VB navigation.


RESULTS
In all patients, TBB was performed safely with no complications. Bronchi seen on VB imaging were highly consistent with the actual structures confirmed using fiberoptic bronchoscopy. Following VB navigation, the endobronchial ultrasonography (EBUS) probe was inserted into third- to sixth-generation bronchi. Twenty-four lesions (80%) were visualized on EBUS images. Average durations of the initial EBUS examination of lesions, first biopsy, and the total procedure were 9.56 min, 11.99 min, and 25.72 min, respectively. Nineteen lesions (63.3%) were diagnosed from histopathologic or cytologic examination. Diagnostic sensitivities were 44.4% (8 of 18) for lesions < 20 mm in mean diameter and 91.7% (11 of 12) for lesions 20 to 30 mm in mean diameter.


CONCLUSIONS
In summary, TBB using EBUS-GS with VB navigation was safely performed and was effective in diagnosing small peripheral pulmonary lesions.
Asahina
Hajime
H
First Department of Medicine, Hokkaido University School of Medicine, North 15, West 7, Kitaku, Sapporo 060-8638, Japan.
Yamazaki
Koichi
K
Onodera
Yuya
Y
Kikuchi
Eiki
E
Shinagawa
Naofumi
N
Asano
Fumihiro
F
Nishimura
Masaharu
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001980:Bronchi / Q000473:pathology*; D001999:Bronchoscopy / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013238:Stereotaxic Techniques