Author of

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  P1.05 - Interventional Diagnostics/Pulmonology (Not CME Accredited Session) (ID 937)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

  • 26478

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    P1.05-04 - Cone-Beam CT Confirms the Status of Transbronchial Biopsy Under Virtual Bronchoscopic Navigation for Peripheral Lung Lesions (ID 13788)

    16:45 - 18:00  |  Author(s): Eman Ali
    • Abstract
    • Slides

    Background
    

    CT guided transbronchial biopsy has been reported to have a high accuracy for the diagnosis of peripheral lung lesion. Recently, C-arm cone-beam CT (CBCT) with a flatpanel detector system has been developed and offers greater flexibility in orientating the detector around the patient than closed CT gantry systems. We have introduced CBCT to the transbronchial lung biopsy and report the usefulness of the method.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Patients with undiagnosed peripheral lung lesions 3 cm or less in size between June 2016 and August 2017 were enrolled．An ultrathin bronchoscope was inserted as far as possible to the target bronchus by comparing the direct vision and virtual bronchoscopic navigation images displayed simultaneously at same monitor. After reaching the target bronchus, the biopsy forceps was introduced to the target bronchus under conventional fluoroscopy. After the biopsy forceps reach the target bronchus, a CBCT scan data was taken. We categorized the CBCT findings into three types according to positions of the target lesion and the forceps as follows: (Type A: The forceps clearly reached within the lesion. Type B: It could not be categorized into neither type A nor C. Type C: The forceps could not reach the lesion.). The diagnosis yields of biopsy or cytology results was examined.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Twenty-two patients (12 males and 10 females) were included in the study and age ranged from 50 to 87 with average age of 72.8 years. Thirteen lesions were located at the upper lobe, seven lesions at lower lobe and one lesion at middle lobe. Size of the lesions ranged from 9 to 29 mm with average of 20 mm. They included 13 solid lesions and 8 mixed GGO lesions. Regarding CBCT type, A was 16 cases, B was 4 cases, and C was 1 case. Bronchoscopic diagnosis was malignant in 11 cases, benign in 10 cases (4 mycobacterium infections and 6 non-specific inflammations) and undiagnostic in 1 case. There was one false negative case whose bronchoscopic diagnosis as non-specific inflammation was finally proved as adenocarcinoma. Overall the diagnostic accuracy was 91%(20/22). Based on the CBCT category, the accuracy was 100% (17/17), 75% (3/4), 0% (0/1) in Type A, B and C respectively.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    CBCT guided bronchoscopy is valuable in the diagnosis of peripheral lung lesions and useful for confirming the position of the forceps.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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