Efficacy of Combining Multiple Electromagnetic Navigation Bronchoscopy Modalities for Diagnosing Lung Nodules

• Published in: Journal of clinical medicine Vol. 11; no. 24; p. 7341
• Main Authors: Song, Ju Yeun, Shin, Sun Hye, Yoo, Hongseok, Jeong, Byeong-Ho, Um, Sang-Won, Kim, Hojoong, Kwon, O Jung, Lee, Kyungjong
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 10.12.2022; MDPI
• Subjects: Accuracy; Biopsy; Bronchoscopy; Cellular biology; Clinical medicine; Lungs; Medical imaging; Navigation systems; Patients; Software; Success; Surveillance; lung nodule; electromagnetic navigation bronchoscopy; radial endobronchial ultrasound-guided transbronchial biopsy
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11247341

Electromagnetic navigation bronchoscopy (ENB) is one of the non-invasive methods used for lung nodule biopsy. We evaluated the efficacy of combining radial endobronchial ultrasound (R-EBUS)-guided transbronchial lung biopsy (TBLB) with ENB-guided TBLB or transbronchial needle aspiration (TBNA) for diagnosing lung nodules. Forty patients with a lung nodule underwent ENB-TBLB or TBNA, followed by R-EBUS-TBLB if available. The final diagnosis was benign or malignant, depending on the surgical pathology or 24-month follow-up computed tomography (CT). We compared the sensitivity, negative predictive value, and accuracy between combinations of procedures. The mean nodule size was 21.65 mm, and 60.0% of the nodules were solid. The bronchus was within the nodule in 67.5% and 65.0% of cases examined using CT and R-EBUS, respectively. The accuracies of ENB-TBLB alone, ENB-TBLB/TBNA, and R-EBUS-TBLB plus ENB-TBLB/TBNA were 74.4%, 82.5%, and 90.0%, respectively. The sensitivity levels of the aforementioned procedures were 69.8%, 78.8%, and 87.9%, respectively. Among 21 patients who underwent both ENB-TBLB and R-EBUS-TBLB, the latter revealed malignant cells in three of nine patients (33.3%) with benign ENB-TBLB results. Combined ENB-TBLB/TBNA and R-EBUS-TBLB had increased sensitivity and diagnostic accuracy for lung nodules. ENB and R-EBUS are complementary; using both modalities improves the sensitivity and accuracy of lung nodule diagnoses.