title: Same-Day Computed Tomographic Chest Imaging for Pulmonary Nodule Targeting with Electromagnetic Navigation Bronchoscopy May Decrease Unnecessary Procedures.
abstract: Bronchoscopy is commonly used for the diagnosis of suspicious pulmonary nodules discovered on computed tomographic (CT) imaging of the chest. Procedural CT imaging for bronchoscopy planning is often completed weeks to months before the date of a scheduled bronchoscopy, which may not allow discovery of a decrease in nodule size or resolution before the bronchoscopic procedure.
  
  
  
  To determine whether same-day CT imaging of the chest discovers partial or total resolution of some lung nodules and thereby reduces unnecessary bronchoscopic procedures.
  
  
  
  We performed a prospective case series study of patients undergoing navigational bronchoscopy using a new technology requiring same-day preprocedural CT imaging at one university teaching hospital. Patients scheduled to undergo bronchoscopy who were found to have partial or complete resolution of their lesion on the same-day CT exam leading to the cancellation of their procedure were identified and further characterized.
  
  
  
  From January 2015 to June 2016, 116 patients were scheduled for navigational bronchoscopy for the diagnosis of a pulmonary lesion. Of the 116 patients scheduled, 8 (6.9%) had a decrease in size or resolution of their lesion, leading to the cancellation of their procedure. The number needed to screen to prevent one unnecessary procedure was 15. For cancelled cases, the average time from initial CT prompting referral for bronchoscopy to the day of procedure scan was 53 days.
  
  
  
  Time from initial imaging to day of procedure is variable, occasionally allowing enough time for lesions to resolve, thereby obviating the need for biopsy. Same-day imaging may decrease unnecessary procedural risk.
authors.affiliation: 1 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
authors.forename: Roy W
authors.initials: RW
authors.lastname: Semaan
authors.affiliation: 1 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: 1 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
authors.forename: David
authors.initials: D
authors.lastname: Feller-Kopman
authors.affiliation: 1 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Lerner
authors.affiliation: 1 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Mallow
authors.affiliation: 1 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Thiboutot
authors.affiliation: 2 Section of Interventional Pulmonology, Division of Pulmonary Medicine, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Sixto A
authors.initials: SA
authors.lastname: Arias
authors.affiliation: 1 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
authors.forename: Lonny B
authors.initials: LB
authors.lastname: Yarmus
mesh_terms: D000328:Adult; D001706:Biopsy; D001999:Bronchoscopy; D055590:Electromagnetic Phenomena; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: bronchoscopy; nodule resolution; pulmonary mass; pulmonary nodule