Advances in navigating to the nodule and targeting.

IF 2.8 3区医学 Q2 RESPIRATORY SYSTEM Current Opinion in Pulmonary Medicine Pub Date : 2024-01-01 Epub Date: 2023-11-06 DOI:10.1097/MCP.0000000000001021

Jeffrey Graham, Madeleine Basist, Laura Frye, Abhinav Agrawal, Faria Nasim

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Abstract

Purpose of review: The multitude of available platforms and imaging modalities for navigational bronchoscopy, in combination with the various sampling tools that can be used intra-procedurally, is complex. This review seeks to describe the recent developments in peripheral bronchoscopy in regards to navigation, imaging, and sampling target lesions in the pulmonary parenchyma.

Recent findings: Robotic assisted bronchoscopy has improved navigation to the peripheral airways for sampling of peripheral parenchymal lesions. These navigational platforms use innovative technology utilizing electromagnetic navigation and shape-sensing technology for guidance. The greatest improvement has been the stabilization of the robotic scope in the periphery to allow for accurate sampling. Despite improvements in these platforms, limitations of CT to body divergence continue to impact navigation to the lesion and therefore diagnostic yield of the procedure. Advanced intraprocedural imaging with cone beam CT or augmented fluoroscopy has been a recent focus to improve this area. Further, the adoption of newer sampling tools, such as cryobiopsy, offers the possibility of increased diagnostic yield.

Summary: The developments in advanced bronchoscopy will impact the role of biopsy in the diagnosis of peripheral pulmonary parenchymal lesions.

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导航到结节和靶向方面的进展。

综述目的：导航支气管镜检查的多种可用平台和成像模式，加上可在手术中使用的各种采样工具，是复杂的。这篇综述旨在描述外周支气管镜在导航、成像和肺实质靶病变取样方面的最新进展。最近的发现：机器人辅助支气管镜检查改善了对外周气道的导航，以对外周实质病变进行采样。这些导航平台使用创新技术，利用电磁导航和形状传感技术进行制导。最大的改进是机器人瞄准镜在外围的稳定性，以实现准确的采样。尽管这些平台有所改进，但CT对身体发散性的限制继续影响对病变的导航，从而影响手术的诊断效果。锥形束CT或增强荧光镜检查的先进术中成像是最近改善这一领域的焦点。此外，采用较新的采样工具，如冷冻活检，提供了提高诊断率的可能性。摘要：晚期支气管镜检查的发展将影响活检在外周肺实质病变诊断中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Pulmonary Medicine 医学-呼吸系统

CiteScore

6.20

自引率

0.00%

发文量

109

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Pulmonary Medicine is a highly regarded journal offering insightful editorials and on-the-mark invited reviews, covering key subjects such as asthma; cystic fibrosis; infectious diseases; diseases of the pleura; and sleep and respiratory neurobiology. Published bimonthly, each issue of Current Opinion in Pulmonary Medicine introduces world renowned guest editors and internationally recognized academics within the pulmonary field, delivering a widespread selection of expert assessments on the latest developments from the most recent literature.