https://doi.org/10.4081/monaldi.2025.3223
Virtual bronchoscopic navigation and guided radial endobronchial ultrasound for peripheral pulmonary lesions: harmonizing modalities to optimize accuracy
Submitted: October 11, 2024
Accepted: November 29, 2024
Published: January 29, 2025
Accepted: November 29, 2024
Abstract Views: 35
PDF_EARLY VIEW: 17
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Peripheral pulmonary lesions (PPLs) present a significant diagnostic challenge due to their location beyond the reach of traditional bronchoscopy. With lung cancer being the leading cause of cancer-related mortality worldwide, accurate and early diagnosis of PPLs is crucial. Virtual bronchoscopic navigation (VBN) combined with radial endobronchial ultrasound (R-EBUS) has emerged as a promising technique to enhance the diagnostic yield for these lesions. This retrospective observational study evaluated the diagnostic yield of VBN-guided R-EBUS in patients with PPLs identified on computed tomography. The study included nine patients who underwent VBN-guided R-EBUS biopsy sampling. Patient demographics, lesion characteristics, and procedural outcomes were analyzed using descriptive and inferential statistics. The mean age of the patients was 57.33 years, with a mean lesion size of 3.24 cm. The diagnostic yield of VBN-guided R-EBUS was 77.7% (95% confidence interval: 68.5-85.8%). Non-small cell carcinoma was the most frequent histopathological diagnosis (55.5%). Complications included bleeding in two patients (22.2%) and bronchospasm in one patient (11.1%), all managed conservatively. VBN-guided R-EBUS provides high diagnostic accuracy and a low risk of complications in patients with PPLs.
Faurschou P, Milman N, Dirksen A, et al. Classification of pulmonary lesions into central and peripheral with a template applied on chest X-ray. Respir Med 1996;90:349-52.
DOI: https://doi.org/10.1016/S0954-6111(96)90131-6
Giri M, Dai H, Puri A, et al. Advancements in navigational bronchoscopy for peripheral pulmonary lesions: a review with special focus on virtual bronchoscopic navigation. Front Med 2022;9:989184.
DOI: https://doi.org/10.3389/fmed.2022.989184
Khan T, Usman Y, Abdo T, et al. Diagnosis and management of peripheral lung nodule. Ann Transl Med 2019;7:348.
DOI: https://doi.org/10.21037/atm.2019.03.59
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209-49.
DOI: https://doi.org/10.3322/caac.21660
Singh N, Agrawal S, Jiwnani S, et al. Lung cancer in India. J Thorac Oncol 2021;16:1250-66.
DOI: https://doi.org/10.1016/j.jtho.2021.02.004
Gould MK, Fletcher J, Iannettoni MD, et al. Evaluation of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007;132:108S-30S.
DOI: https://doi.org/10.1378/chest.07-1353
Rivera MP, Mehta AC, Wahidi MM. Establishing the diagnosis of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013;143:e142S-65S.
DOI: https://doi.org/10.1378/chest.12-2353
Jacomelli M, Demarzo SE, Cardoso PFG, et al. Radial-probe EBUS for the diagnosis of peripheral pulmonary lesions. J Bras Pneumol 2016;42:248-53.
DOI: https://doi.org/10.1590/s1806-37562015000000079
Sainz Zuñiga PV, Vakil E, Molina S, et al. Sensitivity of radial endobronchial ultrasound-guided bronchoscopy for lung cancer in patients with peripheral pulmonary lesions: an updated meta-analysis. Chest 2020;157:994-1011.
DOI: https://doi.org/10.1016/j.chest.2019.10.042
Herth FJF, Eberhardt R, Becker HD, Ernst A. Endobronchial ultrasound-guided transbronchial lung biopsy in fluoroscopically invisible solitary pulmonary nodules: a prospective trial. Chest 2006;129:147-50.
DOI: https://doi.org/10.1378/chest.129.1.147
Kim SH, Kim MH, Lee MK, Eom JS. Problems in the pathologic diagnosis of suspected lung cancer. Tuberc Respir Dis 2023;86:176-82.
DOI: https://doi.org/10.4046/trd.2022.0142
Giri M, Puri A, Wang T, et al. Virtual bronchoscopic navigation versus non-virtual bronchoscopic navigation assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: a systematic review and meta-analysis. Ther Adv Respir Dis 2021;15:17534666211017048.
DOI: https://doi.org/10.1177/17534666211017048
Xu C, Yuan Q, Wang Y, et al. Usefulness of virtual bronchoscopic navigation combined with endobronchial ultrasound guided transbronchial lung biopsy for solitary pulmonary nodules. Medicine 2019;98:e14248.
DOI: https://doi.org/10.1097/MD.0000000000014248
Ishida T, Asano F, Yamazaki K, et al. Virtual bronchoscopic navigation combined with endobronchial ultrasound to diagnose small peripheral pulmonary lesions: a randomised trial. Thorax 2011;66:1072-7.
DOI: https://doi.org/10.1136/thx.2010.145490
Han Y, Kim HJ, Kong KA, et al. Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: a systematic review and meta-analysis. PloS One 2018;13:e0191590.
DOI: https://doi.org/10.1371/journal.pone.0191590
Callister MEJ, Baldwin DR, Akram AR, et al. British Thoracic Society guidelines for the investigation and management of pulmonary nodules. Thorax 2015;70:ii1-54.
DOI: https://doi.org/10.1136/thoraxjnl-2015-207168
Dhillon SS, Harris K. Bronchoscopy for the diagnosis of peripheral lung lesions. J Thorac Dis 2017;9:S1047-58.
DOI: https://doi.org/10.21037/jtd.2017.05.48
Levine MZ, Goodman S, Lentz RJ, et al. Advanced bronchoscopic technologies for biopsy of the pulmonary nodule: a 2021 review. Diagnostics 2021;11:2304.
DOI: https://doi.org/10.3390/diagnostics11122304
Ganaie B, Denny N, Mills J, Munavvar M. Comparison of radial mini probe endobronchial ultrasound with and without virtual bronchoscopic navigation to sample peripheral pulmonary lesions; a retrospective analysis. Eur Respir J 2016;48:PA4672.
DOI: https://doi.org/10.1183/13993003.congress-2016.PA4672
Tian S, Li X, Liu J, Wang X, et al. Radial endobronchial ultrasound - guided bronchoscopy for the diagnosis of peripheral pulmonary lesions: a systematic review and meta-analysis of prospective trials. Heliyon 2024;10:e29446.
DOI: https://doi.org/10.1016/j.heliyon.2024.e29446
Prado RMG, Cicenia J, Almeida FA. Robotic-assisted bronchoscopy: a comprehensive review of system functions and analysis of outcome data. Diagnostics 2024;14:399.
DOI: https://doi.org/10.3390/diagnostics14040399
Verhoeven RLJ, Kops SEP, Wijma IN, et al. Cone-beam CT in lung biopsy: a clinical practice review on lessons learned and future perspectives. Ann Transl Med 2023;11:361.
DOI: https://doi.org/10.21037/atm-22-2845
Jain A, Sarkar A, Husnain SMN, et al. Digital tomosynthesis: review of current literature and its impact on diagnostic bronchoscopy. Diagnostics 2023;13:2580.
DOI: https://doi.org/10.3390/diagnostics13152580
How to Cite
Mrigpuri, Parul, Sidharth Raj Yadav, Divyendu Sharma, Sonam Spalgais, Vidushi Rathi, Nitin Goel, Balakrishnan Menon, and Raj Kumar. 2025. “Virtual Bronchoscopic Navigation and Guided Radial Endobronchial Ultrasound for Peripheral Pulmonary Lesions: Harmonizing Modalities to Optimize Accuracy”. Monaldi Archives for Chest Disease, January. https://doi.org/10.4081/monaldi.2025.3223.
Copyright (c) 2025 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Manas Mengar, Nitesh Gupta, Shibdas Chakrabarti, Vipin Aggarwal, Kalindi Shah, Pranav Ish, Cocaine abuse induced diffuse alveolar haemorrhage: a rare entity , Monaldi Archives for Chest Disease: Vol. 90 No. 1 (2020)
- Neeraj Kumar Gupta, Rohit Kumar, Harsh Vardhan Puri, Nitesh Gupta, Siddharth Raj Yadav, Pranav Ish, Chest percussion, a common yet underutilized art , Monaldi Archives for Chest Disease: Vol. 90 No. 3 (2020)
- Ravindra Nath, Neeraj Kumar Gupta, Amandeep Jaswal, Sparsh Gupta, Navjot Kaur, Santvana Kohli, Anirudh saxena, Pranav Ish, Rohit Kumar, Poornima Tiwari, Mukesh Kumar, Jugal Kishore, Geeta Yadav, Fellisha Marwein, Nitesh Gupta, Mortality among adult hospitalized patients during the first wave and second wave of COVID-19 pandemic at a tertiary care center in India , Monaldi Archives for Chest Disease: Vol. 92 No. 2 (2022)
- Nitin Goel, Sonam Spalgais, Parul Mrigpuri, Madhu Khanna, Balakrishnan Menon, Raj Kumar, Characteristics of COVID-19 at a non-COVID tertiary pulmonary care centre in Delhi, India , Monaldi Archives for Chest Disease: Vol. 90 No. 4 (2020)
- Anshul Mittal, Megha Varshney, Vidushi Rathi, Pranav Ish, High flow nasal cannula in acute hypercapnic exacerbation of chronic obstructive pulmonary disease: an emerging utility , Monaldi Archives for Chest Disease: Vol. 90 No. 1 (2020)
- Vishal Chopra, Baljeet Singh Virk, Siddharth Chopra, Monika Bansal, Jain Chungath, Application of CBNAAT (Xpert MTB/RIF assay) in new smear negative pulmonary tuberculosis patients , Monaldi Archives for Chest Disease: Vol. 90 No. 1 (2020)
- Gopal Chawla, Ram Niwas, Nishant Kumar Chauhan, Naveen Dutt, Taruna Yadav, Priyank Jain, Pancreatic pleural effusion masquerading as right sided tubercular pleural effusion , Monaldi Archives for Chest Disease: Vol. 89 No. 3 (2019)
- Rishabh Raj, Kavitha Venkatnarayan, Uma Maheswari Krishnaswamy, Uma Devaraj, Priya Ramachandran, Jayanthi Savio, A filamentous trio , Monaldi Archives for Chest Disease: Vol. 90 No. 4 (2020)
- Alice Biffi, Giulia Dei, Federica De Giacomi, Anna Stainer, Lorenzo Olmo Parma, Maria Rosa Pozzi, Paola Faverio, Alberto Pesci, Non-specific interstitial pneumonia and features of connective tissue disease: What are the consequences of a different point of view? , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- Carla Simonelli, Mara Paneroni, Aubin Georges Fokom, Manuela Saleri, Ilaria Speltoni, Irene Favero, Francesca Garofali, Simonetta Scalvini, Michele Vitacca, How the COVID-19 infection tsunami revolutionized the work of respiratory physiotherapists: an experience from Northern Italy , Monaldi Archives for Chest Disease: Vol. 90 No. 2 (2020)
<< < 24 25 26 27 28 29 30 31 32 33 > >>
You may also start an advanced similarity search for this article.
