Diagnostic accuracy and safety of electromagnetic navigation bronchoscopy for percutaneously inaccessible lung nodules = Diagnostic accuracy and safety of electromagnetic navigation bronchoscopy for percutaneously inaccessible lung nodules

다국어 초록 (Multilingual Abstract)

Introduction: Although electromagnetic navigation bronchoscopy (ENB) is a useful emerging technique to evaluate peripheral lung lesions, little is known about its accuracy and safety in diagnosing pulmonary nodules that cannot be accessed using a percutaneous transthoracic needle biopsy (PCNB).
Methods: As a single center prospective pilot study, we recruited patients with peripheral pulmonary nodules who were difficult to undergo biopsy by PCNB methods. Patients who confirmed an endobronchial lesions by conventional bronchoscopy before ENB were excluded. We performed ENB under moderate sedation for histologic diagnosis.
Results: ENB guided biopsy was conducted for 26 pulmonary nodules in 26 patients between September 2017 and July 2018. The mean diameter of the biopsied nodules was 22 mm (range, 13-41) and more than half of the nodules (58.3%) were located in upper lobe. ENB guided biopsy was successfully performed in 96.2% (25/26) and only failed one case to approach the target lesion. The diagnostic accuracy of ENB guided biopsy was 64.0% (16/25). There were 5 cases (20%) in which the follow-up period was insufficient and the result of biopsy could not be determined. Among the 26 patients, the biopsy related pneumothorax occurred in one patients (1/26, 3.8%), requiring chest tube drainage. There was no major bleeding or death related to the procedure.
Conclusions: In this study, ENB guided biopsy showed acceptable accuracy, and safety profile to evaluate peripheral pulmonary nodules even if percutaneous approach was difficult and dangerous.