A virtual bronchoscopic navigation system for pulmonary peripheral lesions.
OBJECTIVE
We performed ultrathin bronchoscopy for pulmonary peripheral lesions using a system that displays virtual bronchoscopy (VB) images to the lesion simultaneously with actual images and navigates the bronchoscope to the target bronchus. We then evaluated the system with regard to its usefulness and problems.


METHODS
A pilot study.


METHODS
A tertiary teaching hospital.


METHODS
The subjects were consecutive patients with small pulmonary peripheral lesions (< or = 30 mm).


METHODS
Using this system, the rotation, advancement, and retreat of VB images were possible, and the bronchus into which the bronchoscope was to be advanced was displayed. VB images were displayed along with actual images, and the ultrathin bronchoscope was advanced to the target bronchus under direct vision. Under CT and radiographic fluoroscopy, a pair of forceps was inserted into the lesion via the bronchoscope. Thin-section CT images were obtained; after confirming the advancement of the bronchoscope into the target bronchus and the arrival of the forceps at the lesion, a biopsy was performed.


RESULTS
Study subjects included 37 patients with 38 lesions. VB images to a median of the sixth- (third- to ninth-) order bronchi could be produced. Using this system, the ultrathin bronchoscope could be advanced into the planned route for 36 of the 38 lesions (94.7%). The system was used for a median of 2.6 min, and the median examination time was 24.9 min. The biopsy forceps could be advanced to the lesion in 33 of the 38 lesions (86.8%), and diagnosis was possible for 31 lesions (81.6%).


CONCLUSIONS
This navigation system is useful for ultrathin bronchoscopy for pulmonary peripheral lesions.
Asano
Fumihiro
F
Department of Respiratory Medicine, Gifu Prefectural Gifu Hospital, Japan. asano-fm@ceres.ocn.ne.jp
Matsuno
Yoshihiko
Y
Shinagawa
Naofumi
N
Yamazaki
Koichi
K
Suzuki
Toshitaka
T
Ishida
Takashi
T
Moriya
Hiroshi
H
D000328:Adult; D000368:Aged; D001706:Biopsy; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D004867:Equipment Design; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014584:User-Computer Interface