title: A novel platform for electromagnetic navigated ultrasound bronchoscopy (EBUS).
abstract: OBJECTIVE
  Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) of mediastinal lymph nodes is essential for lung cancer staging and distinction between curative and palliative treatment. Precise sampling is crucial. Navigation and multimodal imaging may improve the efficiency of EBUS-TBNA. We demonstrate a novel EBUS-TBNA navigation system in a dedicated airway phantom.
  
  
  METHODS
  Using a convex probe EBUS bronchoscope (CP-EBUS) with an integrated sensor for electromagnetic (EM) position tracking, we performed navigated CP-EBUS in a phantom. Preoperative computed tomography (CT) and real-time ultrasound (US) images were integrated into a navigation platform for EM navigated bronchoscopy. The coordinates of targets in CT and US volumes were registered in the navigation system, and the position deviation was calculated.
  
  
  RESULTS
  The system visualized all tumor models and displayed their fused CT and US images in correct positions in the navigation system. Navigating the EBUS bronchoscope was fast and easy. Mean error observed between US and CT positions for 11 target lesions (37 measurements) was [Formula: see text] mm, maximum error was 5.9 mm.
  
  
  CONCLUSIONS
  The feasibility of our novel navigated CP-EBUS system was successfully demonstrated. An EBUS navigation system is needed to meet future requirements of precise mediastinal lymph node mapping, and provides new opportunities for procedure documentation in EBUS-TBNA.
authors.affiliation: Department of Thoracic Medicine, St. Olavs Hospital, Postboks 3250, Sluppen, 7006, Trondheim, Norway. hannesorger@msn.com.|Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), AHL-senteret, Prinsesse Kristinas gate 3, Trondheim, Norway. hannesorger@msn.com.|Department of Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway. hannesorger@msn.com.
authors.forename: Hanne
authors.initials: H
authors.lastname: Sorger
authors.affiliation: Department Medical Technology, SINTEF, Technology and Society, Trondheim, Norway.
authors.forename: Erlend Fagertun
authors.initials: EF
authors.lastname: Hofstad
authors.affiliation: Department of Thoracic Medicine, St. Olavs Hospital, Postboks 3250, Sluppen, 7006, Trondheim, Norway.|Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), AHL-senteret, Prinsesse Kristinas gate 3, Trondheim, Norway.
authors.forename: Tore
authors.initials: T
authors.lastname: Amundsen
authors.affiliation: Department Medical Technology, SINTEF, Technology and Society, Trondheim, Norway.
authors.forename: Thomas
authors.initials: T
authors.lastname: Langø
authors.affiliation: Department of Thoracic Medicine, St. Olavs Hospital, Postboks 3250, Sluppen, 7006, Trondheim, Norway.|Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), AHL-senteret, Prinsesse Kristinas gate 3, Trondheim, Norway.
authors.forename: Håkon Olav
authors.initials: HO
authors.lastname: Leira
mesh_terms: D001999:Bronchoscopy / Q000379:methods*; D055590:Electromagnetic Phenomena; D019160:Endosonography / Q000379:methods*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008482:Mediastinum / Q000000981:diagnostic imaging* / Q000473:pathology; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D019047:Phantoms, Imaging; D014057:Tomography, X-Ray Computed
keywords: Convex probe endobronchial ultrasound (CP-EBUS); Electromagnetic navigation; Endobronchial ultrasound; Multimodal image fusion; Navigated EBUS; Navigated ultrasound bronchoscopy