Abstract
Background: Achieving higher yields in solitary pulmonary nodule (SPN) diagnosis has been demonstrated by combining multiple modalities. Radial probe endobronchial ultrasound (R-EBUS) has been routinely utilized to safely identify SPNs for sampling in order to increase yields. Archimedes® virtual bronchoscopic navigation (VBN) system is a diagnostic modality to access and sample SPNs under fused-fluoroscopic guidance. Aim: To compare biopsy yield and performance of VBN system with and without confirmation by R-EBUS prior to sampling. Methods: A total of 100 patients with SPN ≥8 mm completed transbronchial biopsy (TBB) procedure in 10 hospitals. Patients were registered to align the CT with the live fluoroscopic view. The scope was navigated to create an access path to the SPN using the VBN system and R-EBUS was added in certain TBB procedures to confirm the SPN location. Biopsy forceps +/- needle were applied under fluoroscopic guidance to obtain tissue samples. Results: A data summary of 102 biopsied SPNs is presented in the table. Value is reported in median (interquartile range [quartile1-quartile3]) (Fig. 1). Conclusion: Higher yield for VBN alone suggests combination with R-EBUS may be beneficial under certain circumstances but not necessarily required for all procedures.
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