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BMC Pulmonary Medicine
Published in: BMC Pulmonary Medicine 1/2024

Open Access 01-12-2024 | Bronchoscopy | Research

The accuracy of electromagnetic navigation bronchoscopy compared to fluoroscopy in navigation of transbronchial lung cryobiopsy in patients with interstitial lung disease

Authors: Shiyao Wang, Jinmi Yang, Sa Luo, Jing Geng, Yanhong Ren, Ling Zhao, Min Liu, Dan Wang, Ying Li, Zheng Tian, Wei Liu, Guowu Zhou, Huaping Dai

Published in: BMC Pulmonary Medicine | Issue 1/2024

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Abstract

Background

Safely implementing transbronchial lung cryobiopsy (TBLC) in patients with interstitial lung disease (ILD) requires accurate navigation. Traditional fluoroscopy falls short in reducing the risk of post-procedure pneumothorax. The potential of electromagnetic navigation bronchoscopy (ENB) as a more precise navigation method warrants further exploration.

Methods

A prospective cohort study was conducted on ILD patients undergoing TBLC. Patients were assigned either fluoroscopy or ENB for cryoprobe positioning. Navigation accuracy was evaluated using cone beam computed tomography (CBCT) images as the standard. Safety and diagnostic yield were also observed.

Results

Seventeen patients underwent TBLC, with 10 guided by fluoroscopy and seven by ENB. Fluoroscopy-guided cryoprobe navigation required more adjustments [9/15 (60%) v.s. 1/9 (11%), p = 0.018] for subsequent TBLC compared to ENB, as confirmed by CBCT images. Clinical characteristics, post-procedure complications, and biopsy specimen size showed no significant differences between the groups. Fourteen patients obtained a pathological diagnosis, and 15 received a multidisciplinary discussion (MDD) diagnosis. In the fluoroscopy group, three patients failed to obtain a pathological diagnosis, and two failed to obtain an MDD diagnosis.

Conclusions

ENB demonstrates significantly superior accuracy in TBLC navigation compared to traditional fluoroscopy when CBCT images are used as a reference. Further studies are necessary to determine the value of ENB in TBLC navigation for ILD patients.
Literature
1.
Korevaar DA, Colella S, Fally M, Camuset J, Colby TV, Hagmeyer L, Hetzel J, Maldonado F, Morais A, Ravaglia C, et al. European Respiratory Society guidelines on transbronchial lung cryobiopsy in the diagnosis of interstitial lung diseases. Eur Respir J. 2022;60(5).
2.
Cooley J, Balestra R, Aragaki-Nakahodo AA, Caudell Stamper DN, Sriprasart T, Swank Z, Baughman RP, Benzaquen S. Safety of performing transbronchial lung cryobiopsy on hospitalized patients with interstitial lung disease. Respir Med. 2018;140:71–6.CrossRefPubMed
3.
Zhou G, Ren Y, Li J, Yang T, Su N, Zhao L, Wang D, Li Y, Tian Z, Liu R, et al. Safety and diagnostic efficacy of cone beam computed tomography-guided transbronchial cryobiopsy for interstitial lung disease: a cohort study. Eur Respir J. 2020;56(2).
4.
Troy LK, Grainge C, Corte TJ, Williamson JP, Vallely MP, Cooper WA, Mahar A, Myers JL, Lai S, Mulyadi E, et al. Diagnostic accuracy of transbronchial lung cryobiopsy for interstitial lung disease diagnosis (COLDICE): a prospective, comparative study. Lancet Respir Med. 2020;8(2):171–81.CrossRefPubMed
5.
Kheir F, Uribe Becerra JP, Bissell B, Ghazipura M, Herman D, Hon SM, Hossain T, Khor YH, Knight SL, Kreuter M, et al. Transbronchial lung Cryobiopsy in patients with interstitial lung disease: a systematic review. Ann Am Thorac Soc. 2022;19(7):1193–202.CrossRefPubMed
6.
Fruchter O, Fridel L, Rosengarten D, Raviv Y, Rosanov V, Kramer MR. Transbronchial cryo-biopsy in lung transplantation patients: first report. Respirology. 2013;18(4):669–73.CrossRefPubMed
7.
Colella S, Haentschel M, Shah P, Poletti V, Hetzel J. Transbronchial lung Cryobiopsy in interstitial lung diseases: best practice. Respiration. 2018;95(6):383–91.CrossRefPubMed
8.
Maldonado F, Danoff SK, Wells AU, Colby TV, Ryu JH, Liberman M, Wahidi MM, Frazer L, Hetzel J, Rickman OB, et al. Transbronchial Cryobiopsy for the diagnosis of interstitial lung diseases: CHEST guideline and expert panel report. Chest. 2020;157(4):1030–42.CrossRefPubMed
9.
Sriprasart T, Aragaki A, Baughman R, Wikenheiser-Brokamp K, Khanna G, Tanase D, Kirschner M, Benzaquen S. A single US Center experience of Transbronchial lung Cryobiopsy for diagnosing interstitial lung disease with a 2-scope technique. J Bronchology Interv Pulmonol. 2017;24(2):131–5.CrossRefPubMedPubMedCentral
10.
Benn BS, Romero AO, Bawaadam H, Ivanick N, Lum M, Krishna G. Cone beam CT guidance improves Transbronchial lung Cryobiopsy safety. Lung. 2021;199(5):485–92.CrossRefPubMed
11.
Chen LC, Yang SM, Malwade S, Chang HC, Chang LK, Chung WY, Ko JC, Yu CJ. Cone-beam computed-tomography-derived augmented fluoroscopy-guided biopsy for peripheral pulmonary nodules in a hybrid operating room: a case series. Diagnostics (Basel). 2023;13(6).
12.
Leong S, Ju H, Marshall H, Bowman R, Yang I, Ree AM, Saxon C, Fong KM. Electromagnetic navigation bronchoscopy: a descriptive analysis. J Thorac Dis. 2012;4(2):173–85.PubMedPubMedCentral
13.
Mehta AC, Hood KL, Schwarz Y, Solomon SB. The evolutional history of electromagnetic navigation bronchoscopy: state of the art. Chest. 2018;154(4):935–47.CrossRefPubMed
14.
Ettinger DS, Wood DE, Aisner DL, Akerley W, Bauman JR, Bharat A, Bruno DS, Chang JY, Chirieac LR, D’Amico TA, et al. Non-small cell lung Cancer, version 3.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2022;20(5):497–530.CrossRef
15.
Taton O, Bondue B, Gevenois PA, Remmelink M, Leduc D. Diagnostic yield of combined pulmonary Cryobiopsies and electromagnetic navigation in small pulmonary nodules. Pulm Med. 2018;2018:6032974.CrossRefPubMedPubMedCentral
16.
Kronborg-white S, Bendstrup E, Gori L, Luzzi V, Madsen LB, Poletti V, Rasmussen TR, Trigiani M, Vezzosi S, Tomassetti S. A pilot study on the use of the super dimension navigation system for optimal cryobiopsy location in interstitial lung disease diagnostics. Pulmonology. 2023;29(2):119–23.CrossRefPubMed
17.
Jiang S, Liu X, Chen J, Ma H, Xie F, Sun J. A pilot study of the ultrathin cryoprobe in the diagnosis of peripheral pulmonary ground-glass opacity lesions. Transl Lung Cancer Res. 2020;9(5):1963–73.CrossRefPubMedPubMedCentral
18.
Ravaglia C, Bonifazi M, Wells AU, Tomassetti S, Gurioli C, Piciucchi S, Dubini A, Tantalocco P, Sanna S, Negri E, et al. Safety and diagnostic yield of Transbronchial lung Cryobiopsy in diffuse parenchymal lung diseases: a comparative study versus video-assisted thoracoscopic lung biopsy and a systematic review of the literature. Respiration. 2016;91(3):215–27.CrossRefPubMed
19.
Barisione E, Salio M, Romagnoli M, Praticò A, Bargagli E, Corbetta L. Competence in transbronchial cryobiopsy. Panminerva Med. 2019;61(3):290–7.CrossRefPubMed
20.
Dhooria S, Mehta RM, Srinivasan A, Madan K, Sehgal IS, Pattabhiraman V, Yadav P, Sivaramakrishnan M, Mohan A, Bal A, et al. The safety and efficacy of different methods for obtaining transbronchial lung cryobiopsy in diffuse lung diseases. Clin Respir J. 2018;12(4):1711–20.CrossRefPubMed
21.
Harari S, Cereda F, Pane F, Cavazza A, Papanikolaou N, Pelosi G, Scarioni M, Uslenghi E, Zompatori M, Caminati A. Lung Cryobiopsy for the diagnosis of interstitial lung diseases: a series contribution to a debated procedure. Medicina (Kaunas). 2019;55(9).
22.
Inomata M, Kuse N, Awano N, Tone M, Yoshimura H, Jo T, Minami J, Takada K, Muto Y, Fujimoto K, et al. Utility of radial endobronchial ultrasonography combined with transbronchial lung cryobiopsy in patients with diffuse parenchymal lung diseases: a multicentre prospective study. BMJ Open Respir Res. 2021;8(1).
23.
Li X, Pan J, Ma Y, Ren Y, Gao BL. Diagnosis of diffuse parenchymal lung diseases using transbronchial cryobiopsy guided by endobronchial ultrasound compared to clinicoradiological diagnosis. Quant Imaging Med Surg. 2022;12(2):1139–48.CrossRefPubMedPubMedCentral
24.
Cicenia J, Avasarala SK, Gildea TR. Navigational bronchoscopy: a guide through history, current use, and developing technology. J Thorac Dis. 2020;12(6):3263–71.CrossRefPubMedPubMedCentral
25.
Ozgul G, Cetinkaya E, Ozgul MA, Abul Y, Gencoglu A, Kamiloglu E, Gul S, Dincer HE. Efficacy and safety of electromagnetic navigation bronchoscopy with or without radial endobronchial ultrasound for peripheral lung lesions. Endosc Ultrasound. 2016;5(3):189–95.CrossRefPubMedPubMedCentral
26.
Ma L, Fang Y, Zhang T, Xue P, Bo L, Liu W, Fu E. Comparison in efficacy and safety of forceps biopsy for peripheral lung lesions guided by endobronchial ultrasound-guided sheath (EBUS-GS) and electromagnetic navigation bronchoscopy combined with EBUS (ENB-EBUS). Am J Transl Res. 2020;12(8):4604–11.PubMedPubMedCentral
27.
Ie S, Alper B, Szerlip HM. Respiratory bronchiolitis: an unusual cause of pulmonary infiltrates in a pregnant woman. Am J Med Sci. 2000;320(3):219–21.CrossRefPubMed
28.
Metadata
Title
The accuracy of electromagnetic navigation bronchoscopy compared to fluoroscopy in navigation of transbronchial lung cryobiopsy in patients with interstitial lung disease
Authors
Shiyao Wang
Jinmi Yang
Sa Luo
Jing Geng
Yanhong Ren
Ling Zhao
Min Liu
Dan Wang
Ying Li
Zheng Tian
Wei Liu
Guowu Zhou
Huaping Dai
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2024
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-024-02925-x

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