Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
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Year : 2013  |  Volume : 8  |  Issue : 1  |  Page : 28-32

Rapid on-site evaluation and low registration error enhance the success of electromagnetic navigation bronchoscopy

1 Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey
2 Department of Pathology, Division of Clinical Cytology, Ankara University School of Medicine, Ankara, Turkey
3 Department of Radiology, Ankara University School of Medicine, Ankara, Turkey

Correspondence Address:
Demet Karnak
Ankara University School of Medicine, Department of Chest Diseases, 06100 Cebeci- Ankara
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Source of Support: This study was supported by The Scientific and Technological Research Council of Turkey (TUBITAK), Conflict of Interest: None

DOI: 10.4103/1817-1737.105716

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Background: Electromagnetic navigation bronchoscopy (EMN) is a novel technology which allows localizing peripheral lung lesions and mediastinal lymph nodes for sampling and thus increasing diagnostic yield of Flexible Bronchoscopy. Objectives: A prospective study was conducted to investigate the diagnostic yield of EMN with lower average fiducial target registration error (AFTRE) and rapid on-site evaluation (ROSE). Methods: Consecutive patients with peripheral lung lesion (PL) or enlarged mediastinal lymph node (MLN) which could not be diagnosed by conventional techniques and/or if the patients were not suitable for such interventions were included. The navigation procedure was continued once registration error was reached below/equal to the absolute value of 5 mm. ROSE was performed by an expert cytopathologist. Results: A total of 76 patients; 22 having only PLs, 41 having only MLNs, and 13 having both PLs and MLNs together were enrolled. Thirty-two of 35 PLs (91.4%) and 85 of 102 MLNs (83.3%) were successfully sampled. Overall diagnostic yield was 89.5%. PLs and MLNs were further grouped according to their size (PLs: <20 mm vs ≥20 mm, MLNs: <15 mm vs ≥15 mm). The sampling yield was independent of size for both PL and MLN (P = 1.00, P = 0.38). In diagnostic EMN cases, mean AFTRE was 4.33 ± 0.71 mm, whereas it was 5.16 ± 0.05 mm (P = 0.008) in nondiagnostics. The total duration of procedure was 36.17 ± 9.13 min. Pneumothorax was observed in three patients (3.9%). Conclusion: EMN with low AFTRE in combination with ROSE is a reliable method with high sampling and/or diagnostic rate in PLs and MLNs.

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