UICC World Cancer Congress 2006

Objective:Detection of small nodules in the peripheral lung has been increased due to widespread use of CT scan. Virtual bronchoscopy (VB) is the application of three-dimensional display of bronchial lumen reconstructed from the spiral CT scan data. We have utilized real-time virtual navigation (RVN) to assist bronchoscopy for the diagnosis of peripheral pulmonary lesions. In RVN, implicit images of bronchial path are appeared in the display according to actual bronchoscopic images. In this study, we evaluated efficacy and safety of RVN-assisted bronchoscopy for the diagnosis of peripheral small (< 30 mm) peripheral lesions.

Methods:82 consecutive bronchoscopic cases with RVN were reviewed. A conventional videobronchoscope (Olympus type P240; outer diameter 5.3 mm, and diameter of working channel 2.0 mm) was used in 29 cases, and ultra thin hybrid fiberopticbronchoscope (Olympus type XP260F; 2.8 mm, and 1.2 mm, respectively) in 53 cases. The mean diameter of the lesions was 14.9 mm. All the examinations were performed under X-ray fluoroscopy; therefore we referred three displays, showing the actual bronchoscopic image, virtual image, and fluoroscopic image at the same time. In all cases, pathological specimens were collected by bronchial brushing and/or biopsy.

Results:The average time to begin pathological sampling at the farthest position was 5 min 5 sec. The overall diagnostics rate was 86.7%; with the conventional bronchoscope, 87.5%; with the ultra thin bronchoscope, 86.1%. Bronchoscopy with RVN under fluoroscopy is safe and useful to diagnose small peripheral lesions, and shorten total examination time.