Utility of Virtual Bronchoscopy Navigation in the diagnosis of peripheral lung lesions

Abstract

Introduction: The diagnostic yield of bronchoscopic lung biopsy for peripheral lung lesions is approximately 60%. Virtual bronchoscopic navigation (VBN) aims to improve diagnosis by using 3D CT-reconstruction to plan a route to the lesion. Objective: To assess the diagnostic yield of VBN compared to conventional bronchoscopy for peripheral lung lesions. Methods: Prospective non-randomized single-institution, case series of consecutive cases (n=200) from July 2013 to December 2016 Results: Patient/procedure characteristics of are shown in Table 1 In multivariate logistic regression, after adjustment for lesion size and presence of CT-Bronchus sign, VBN is associated with more positive diagnosis. (Odds ratio 2.3, 95% CI 1.2-4.6, p=0.01) Among the VBN cases, lesion size > 20 mm (81.7% and 48.8%, p=0.001) and positive CT-Bronchus sign (78.8% and 57.1%, p=0.019) were associated with further improvements in yield. The addition of lavage to biopsy increased the diagnosis from 68% to 82%. During VBN, no pneumothorax or care escalation occurred. Conclusion: VBN can improve diagnostic yield without compromising safety.