PUB020 Same Day CT for the Bronchoscopic Diagnosis of SPN May Decrease Unnecessary Procedures in Suspected Lung Cancer Patients

Abstract

Bronchoscopy is commonly used for the diagnosis of solitary pulmonary nodules discovered on CT scanning of the chest. Initial imaging is often completed well before the date of a scheduled test, with repeat imaging generally not repeated prior to the diagnostic procedure. We report a series of resolving nodules seen on chest CT performed the day of electromagnetic navigational bronchoscopy guided biopsy resulting in cancellation of the procedure. A prospective case series for patients undergoing navigational bronchoscopy using a new technology requiring same day CT imaging at a single quaternary care center. Patients undergoing navigational bronchoscopy found to have a decrease in the size or resolution of their nodule leading to the cancellation of their case were included. Included patients had demographic data, lung cancer risk factors as well as pre and day of CT imaging collected. During the study period, 106 patients were scheduled for navigational bronchoscopy for the diagnosis of a pulmonary nodule. Of the 106 patients scheduled 7 (6.6%) had a decrease in the size of/or resolution of their nodule leading to the cancellation of their procedure. The average time from initial CT prompting referral for bronchoscopy to the day of procedure scan for those cancelled was 53 days. Time from initial imaging to day of procedure is variable, occasionally allowing enough time for nodules to resolve obviating the need for biopsy. Although bronchoscopy is a safe and well tolerated procedure, same day imaging may decrease unnecessary procedural risk.