title: Real-time electromagnetic navigation bronchoscopy to peripheral lung lesions using overlaid CT images: the first human study.
abstract: OBJECTIVE
  To characterize the feasibility, accuracy, and safety of the superDimension/Bronchus system (SDBS) [superDimension, Ltd; Hertzliya, Israel] in navigating to previously unreachable peripheral lung lesions and obtaining biopsy specimens.
  
  
  METHODS
  Open-label, prospective, controlled clinical study.
  
  
  METHODS
  Pulmonary institute of a university-affiliated municipal hospital.
  
  
  METHODS
  Thirteen adult candidates for nonemergency bronchoscopy who gave informed consent to participate.
  
  
  METHODS
  The patients underwent flexible bronchoscopy using the SDBS, which is based on real-time CT-guided electromagnetic navigation and is capable of reaching peripheral lung masses beyond the reach of the bronchoscope. A position sensor was used to navigate to and sample the various target lesions for biopsy.
  
  
  RESULTS
  Three-dimensional chest CT was followed by SDBS methodology for marking anatomic landmarks and the target lesion on a virtual bronchoscopy screen and for sampling the lesion. The SDBS assisted in obtaining positive biopsy diagnoses in 9 of 13 cases (69%), with an average navigation accuracy of 5.7 mm. There were no SDBS-related adverse events.
  
  
  CONCLUSIONS
  The SDBS is safe and effective in navigating to peripheral lung lesions located beyond the optic limits of a standard flexible bronchoscope.
authors.affiliation: Pulmonary Institute, Tel Aviv Sourasky Medical Center, Weizman Stt 6, Tel Aviv 64239, Israel. Schwarz@tasmc.health.gov.il
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Schwarz
authors.forename: Joel
authors.initials: J
authors.lastname: Greif
authors.forename: Heinrich D
authors.initials: HD
authors.lastname: Becker
authors.forename: Armin
authors.initials: A
authors.lastname: Ernst
authors.forename: Atul
authors.initials: A
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000473:pathology; D001999:Bronchoscopy; D055590:Electromagnetic Phenomena / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed