Image-Guided Bronchoscopic Sampling Of Peripheral Lesions: A Human Study

William E. Higgins, Rebecca Bascom, Jason D. Gibbs, Michael W. Graham, Duane C. Cornish, Muhammad Khan, Rahul Khare
We consented and enrolled 30 patients with focal lesions, suspected lung cancer and available MDCT scans. The chest scans, generated by either a Siemens Sensation or Emotion scanner, were reconstructed at a resolution of 0.5 mm spacing with 0.75-mmthick 2D axial-plane sections; axial-plane resolution was between 0.52 mm and 0.92 mm. We used the VN system for off-line procedure-planning and live bronchoscopic guidance, as described below. 6 Primary study outcomes for each region of interest
more » ... on of interest (ROI) were: 1) Navigation success: ability of the system to lead the bronchoscopist along the correct route; 2) Sampling success: collection of a satisfactory tissue sample (pathologist interpretation). Reliable biopsy of peripheral nodules is important for lung cancer diagnosis. Peripheral procedures are difficult, however, as the bronchoscopist must navigate through many airway generations to reach an appropriate biopsy site and the target nodule is typically hidden behind the airway walls. 1 CT fluoroscopy and electromagnetic-navigation bronchoscopy have been proposed to assist the bronchoscopist. 2-3 Recently, however, Virtual Bronchoscopic (VB) guidance derived solely from a patient's multidetector CT (MDCT) chest scan has shown promise towards improving peripheral bronchoscopy performance without requiring significant additional hardware. 4-6 We had previously shown that our computer-based virtual navigation (VN) system provides reliable guidance and is feasible for human peripheral nodules. 7 We now present final results for a human study of the VN system for peripheral lesion biopsy.
doi:10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a5171 fatcat:bx3lh6pgdne5vdbs3xjlj7idy4