title: Diagnostic yield of electromagnetic navigational bronchoscopy.
abstract: Peripheral lung nodules (PLNs) are a common and diagnostically challenging finding. Electronavigational bronchoscopy (ENB) is used to increase the diagnostic yield and is considered safe. Multiple factors have been correlated with a better diagnostic yield. We sought to assess the effect of nodule characteristics and prior workup on the diagnostic yield in ENB.
  
  
  
  This was a retrospective chart review of 98 ENB procedures in a community referral center. Two investigators reviewed patients' charts and images independently. Multiple logistic regression analyses was used to determine if factors such as bronchus sign, ground glass opacification (GGO), distance from pleura, prior use of endobronchial ultrasound (EBUS) and positron emission tomography (PET) had an impact on the diagnostic yield.
  
  
  
  We evaluated 98 ENBs performed in 92 patients. Most of the lesions were in the upper lobes. The diagnostic yield was 60%. A PET scan was performed prior to ENB in 47% of cases. EBUS was performed in 24% of cases. Bronchus sign was present in 60% of cases and GGO in only 6% of nodules. The odds ratio for diagnostic yield with a bronchus sign was 1.89 [95% confidence interval (CI): 0.83-4.33] and with nodules showing GGO characteristics it was 4.51 (95% CI: 0.51-39.68). Pneumothorax occurred in 6% of cases.
  
  
  
  In our cohort, diagnostic yield was 60% with a 6% pneumothorax rate. A suggestive trend for the presence of bronchus sign on computed tomography scan, albeit statistically nonsignificant, as a predictor for improved diagnostic yield needs to be validated in a larger cohort.
authors.affiliation: University of South Carolina, School of Medicine, One Medical Park, Suite 300, Columbia, SC 29203, USA mohammed.aljaghbeer@palmettohealth.org.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Jaghbeer
authors.affiliation: Palmetto Health Richland, Columbia SC, USA.
authors.forename: Mathew
authors.initials: M
authors.lastname: Marcus
authors.affiliation: Palmetto Health Richland, Columbia SC, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Durkin
authors.affiliation: Department of Interventional Pulmonology, Frye Regional Hospital, Hickory, NC, USA.
authors.forename: Franklin R
authors.initials: FR
authors.lastname: McGuire
authors.affiliation: Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, OH, USA.
authors.forename: Imran H
authors.initials: IH
authors.lastname: Iftikhar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000379:methods*; D055590:Electromagnetic Phenomena; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000175:diagnosis* / Q000473:pathology; D011030:Pneumothorax / Q000453:epidemiology* / Q000209:etiology; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Diagnostic Yield; Electro-navigational bronchoscopy; Lung Nodules