title: Hybrid DynaCT-guided electromagnetic navigational bronchoscopic biopsy†.
abstract: Electromagnetic navigational bronchoscopy-guided biopsy of small pulmonary nodules can be challenging. Navigational error of the system and movement of the biopsy tool during its deployment adversely affect biopsy success. Furthermore, conventional methods to confirm navigational success such as fluoroscopy and radial endobronchial ultrasound become less useful for the biopsy of small lesions. A hybrid operating theatre can provide unparalleled real-time imaging through DynaCT scan to guide and confirm successful navigation and biopsy of difficult-to-reach or small lesions. We describe our technique for DynaCT image-guided electromagnetic navigational bronchoscopic biopsy of a small pulmonary nodule in the hybrid operating theatre. The advantages, disadvantages and special considerations in adopting this approach are discussed.
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China calvinng@surgery.cuhk.edu.hk.
authors.forename: Calvin S H
authors.initials: CS
authors.lastname: Ng
authors.affiliation: Department of Organ Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Simon C H
authors.initials: SC
authors.lastname: Yu
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Rainbow W H
authors.initials: RW
authors.lastname: Lau
authors.affiliation: Minimally Invasive Thoracic Surgery Center, Hong Kong, China.
authors.forename: Anthony P C
authors.initials: AP
authors.lastname: Yim
mesh_terms: D001706:Biopsy; D001999:Bronchoscopy / Q000379:methods*; D055590:Electromagnetic Phenomena; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D015641:Radiography, Interventional / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014594:Uterine Neoplasms / Q000473:pathology*
keywords: DynaCT; Electromagnetic navigational bronchoscopy; Hybrid operating theatre; Lung biopsy