title: Bronchoscopic-directed diagnosis of peripheral lung lesions suspicious for cancer.
abstract: Bronchoscopic techniques have come a long way in diagnosing peripheral lung lesions suspicious for cancer. Following in the footsteps of gastrointestinal endoscopy. bronchoscopy has become more useful in diagnosing lesions previously thought to be unreachable. The procedure has required miniaturization of the tools used for diagnosis and, as these tools become more sophisticated, bronchoscopists are better able to reach these lesions noninvasively. EBUS has allowed biopsy and penetration with direct visualization of the needle as it enters the lesion. Although EBUS has been used extensively in diagnosing and staging mediastinal lymph nodes, the authors believe this technique has great promise in diagnosing peripheral lung lesions not visualized by fluoroscopy. Electromagnetic navigation adds an entire new dimension to the field of bronchoscopy. The ability to navigate through the bronchial tree in three dimensions and the locatable guide, which is steerable, allow the bronchoscopist to reach peripheral lesions with great success. This technology has great promise in not only diagnosing peripheral lung lesions with greater accuracy, but also may provide a means for therapeutic interventions through this minimally invasive technique. Patients with peripheral lung lesions may now be diagnosed more reliable through endoscopic techniques, avoiding unnecessary surgery in many cases.
authors.affiliation: Pulmonary and Critical Care Medicine, Tufts-New England Medical Center, 750 Washington Street, Box 369, Boston, MA 02111, USA.
authors.forename: Inderjit K
authors.initials: IK
authors.lastname: Hansra
authors.forename: Armin
authors.initials: A
authors.lastname: Ernst
mesh_terms: D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods; D001999:Bronchoscopy / Q000379:methods*; D002986:Clinical Trials as Topic; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography