title: Navigational Bronchoscopy for Early Lung Cancer: A Road to Therapy.
abstract: Peripheral lung nodules remain challenging for accurate localization and diagnosis. Once identified, there are many strategies for diagnosis with heterogeneous risk benefit analysis. Traditional strategies such as conventional bronchoscopy have poor performance in locating and acquiring the required tissue. Similarly, while computerized-assisted transthoracic needle biopsy is currently the favored diagnostic procedure, it is associated with complications such as pneumothorax and hemorrhage. Video-assisted thoracoscopic and open surgical biopsies are invasive, require general anesthesia and are therefore not a first-line approach. New techniques such as ultrathin bronchoscopy and image-based guidance technologies are evolving to improve the diagnosis of peripheral lung lesions. Virtual bronchoscopy and electromagnetic navigation systems are novel technologies based on assisted-computerized tomography images that guide the bronchoscopist toward the target peripheral lesion. This article provides a comprehensive review of these emerging technologies.
authors.affiliation: Department of Interventional Pulmonary Medicine, Cork University Hospital/University College Cork, Cork, Ireland. drkhan95@hotmail.com.
authors.forename: Kashif Ali
authors.initials: KA
authors.lastname: Khan
authors.affiliation: School of Engineering, University College Cork, Cork, Ireland.
authors.forename: Pietro
authors.initials: P
authors.lastname: Nardelli
authors.affiliation: School of Engineering, University College Cork, Cork, Ireland.
authors.forename: Alex
authors.initials: A
authors.lastname: Jaeger
authors.affiliation: School of Engineering, University College Cork, Cork, Ireland.
authors.forename: Conor
authors.initials: C
authors.lastname: O'Shea
authors.affiliation: School of Engineering, University College Cork, Cork, Ireland.
authors.forename: Padraig
authors.initials: P
authors.lastname: Cantillon-Murphy
authors.affiliation: Department of Interventional Pulmonary Medicine, Cork University Hospital/University College Cork, Cork, Ireland.
authors.forename: Marcus P
authors.initials: MP
authors.lastname: Kennedy
mesh_terms: D001999:Bronchoscopy / Q000379:methods*; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology; D018570:Risk Assessment; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014055:Tomography, Emission-Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: Bronchoscopy; Computerized tomography (CT); Electromagnetic navigation; Image guidance; Lung cancer; Peripheral lung lesion; Respiratory