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The additional diagnostic value of virtual bronchoscopy navigation in patients with pulmonary nodules - The NAVIGATOR study.
Hiddinga, Birgitta I; Slebos, Dirk-Jan; David Koster, T; Hijmering-Kappelle, Lucie B M; Hiltermann, T Jeroen N; Kievit, Hanneke; van der Wekken, Anthonie J; de Jonge, Gonda; Vliegenthart, Rozemarijn; Van De Wauwer, Caroline; Timens, Wim; Bensch, Frederike.
  • Hiddinga BI; Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, the Netherlands. Electronic address: b.i.hiddinga@umcg.nl.
  • Slebos DJ; Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, the Netherlands.
  • David Koster T; Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, the Netherlands.
  • Hijmering-Kappelle LBM; Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, the Netherlands.
  • Hiltermann TJN; Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, the Netherlands.
  • Kievit H; Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, the Netherlands.
  • van der Wekken AJ; Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, the Netherlands.
  • de Jonge G; Department of Radiology, University Medical Center Groningen, University of Groningen, the Netherlands.
  • Vliegenthart R; Department of Radiology, University Medical Center Groningen, University of Groningen, the Netherlands.
  • Van De Wauwer C; Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands.
  • Timens W; Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, the Netherlands.
  • Bensch F; Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, the Netherlands.
Lung Cancer ; 177: 37-43, 2023 03.
Article en En | MEDLINE | ID: mdl-36708592
ABSTRACT

BACKGROUND:

The number of solitary pulmonary nodules to be evaluated is expected to increase and therefore we need to improve diagnostic and therapeutic tools to approach these nodules. To prevent patients from futile invasive procedures and receiving treatment without histological confirmation of cancer, we evaluated the value of virtual bronchoscopy navigation to obtain a diagnosis of the solitary pulmonary nodule in a real-world clinical setting.

METHODS:

In the NAVIGATOR single center, prospective, observational cohort study patients underwent a virtual bronchoscopy navigation procedure with or without guide sheet tunnelling to assess a solitary pulmonary nodule. Nodules were considered not accessible if a diagnosis could not be obtained by either by CT-guided transthoracic biopsy or conventional bronchoscopy.

RESULTS:

Between February 2021 and January 2022 35 patients underwent the virtual bronchoscopy navigation procedure. The overall diagnostic yield was 77% and was dependent on size of the nodule and chosen path, with highest yield in lesions with an airway path. Adverse events were few and manageable.

CONCLUSION:

Virtual bronchoscopy navigation with or without sheet tunnelling is a new technique with a good diagnostic yield, also in patients in whom previously performed procedures failed to establish a diagnosis and/or alternative procedures are considered not feasible based on expected yield and/or safety. Preventing futile or more invasive procedures like surgery or transthoracic punctures with a higher complication rate is beneficial for patients, and allowed treatment adaptation in two-third of the analyzed patient population.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Nódulo Pulmonar Solitario / Nódulos Pulmonares Múltiples / Neoplasias Pulmonares Tipo de estudio: Diagnostic_studies / Observational_studies Límite: Humans Idioma: En Año: 2023 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Nódulo Pulmonar Solitario / Nódulos Pulmonares Múltiples / Neoplasias Pulmonares Tipo de estudio: Diagnostic_studies / Observational_studies Límite: Humans Idioma: En Año: 2023 Tipo del documento: Article