Electromagnetic Navigation Diagnostic Bronchoscopy (ENB)

Year 2018, Volume: 9 Issue: 3, 237 - 243, 30.09.2018

Serda Kanbur Metin , Çağatay Tezel

https://doi.org/10.18663/tjcl.356585

Abstract

Advances in computer technology have permitted
development of virtual reality images of the tracheobronchial tree using data
sets derived from helical CT of the chest. Peripheral pulmonary lesions (PPL) are common incidental findings. Their
rising incidence has paralleled the increasing use of computed tomography (CT)
as CT is approximately three times more sensitive than plain chest radiography
(CXR) scans. Electromagnetic navigation bronchoscopy (ENB) is an exciting new
bronchoscopic technique that promises accurate navigation to peripheral
pulmonary target lesions. CT-guided transthoracic needle aspiration (TTNA)
is a common method of obtaining tissue and whilst its pooled sensitivity for
malignancy of %90 is impressive it also has a false negative rate of %20-30. Furthermore
it is complicated by minor pneumothorax in approximately %25 of cases and major
pneumothorax requiring a chest tube in %5 of cases. The main advantage of using
bronchoscopic techniques rather than transthoracic biopsy is its superior
safety profile. Electromagnetic
navigation-guided bronchoscopy has the potential to improve the diagnostic
yield of transbronchial biopsies without additional fluoroscopic guidance, and
may be useful in the early diagnosis of lung cancer, particularly in
nonoperable patients.

Keywords

3-dimensional spiral CT; endoscopic guidance navigation, Electromagnetic navigation bronchoscopy

Elektromanyetik Navigasyon Diyagnostik Bronkoskopi (ENB)

Abstract

Bilgisayar teknolojisindeki ilerlemeler, spiral toraks bilgisayarlı (BT)
tomografisinden elde edilen verilerin kullanılarak, trakeobronşiyal ağacın
sanal gerçeklikteki görüntülerinin oluşturulmasına imkan tanımaktadır. Periferik
pulmoner lezyonlar yapılan görüntüleme tekniklerinde raslantısal olarak yaygın
şekilde görülmektedir.  Bu lezyonların
giderek artan sıklıkta görülmesi, direk grafilerden üç kat daha duyarlı olan BT
kullanımını artırmaktadır. Yeni bir bronkoskopik teknik olan elektromanyetik navigasyon diyagnostik
bronkoskopi (ENB), periferal pulmoner lezyonlarda doğru tanı oranını artırmada
gelecek vadeden bir yöntem olmaya başlamıştır. Bu lezyonların tanısında yaygın
olarak kullanılan BT eşliğinde yapılan ince iğne aspirasyon biyopsisi (TTİAB),
malign lezyonlarda %90 sensitiviteye sahipken %20 ila 30 oranında yanlış negatiflik
oranına sahiptir. Ayrıca bu yöntem yaklaşık %25 oranında minör pnömotoraksa yol
açmaktayken, %5 oranında göğüs tüpü drenajına gerek duyulmaktadır. Bronkoskopik
tekniklerin, transtorasik biyopsiye göre ana avantajı daha üstün bir güvenliğe
sahip olmasıdır. Elektromanyetik navigasyon diyagnostik bronkoskopi (ENB), ek
floroskopik yöntem kullanmadan, özellikle inoperabl hastalarda erken tanı
doğruluğunu artırmada faydalı olabilir.

Keywords

3-boyutlu spiral BT; endoskopik navigasyon, Elektromanyetik navigasyon

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