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. 2012 Apr 1;4(2):173-85.
doi: 10.3978/j.issn.2072-1439.2012.03.08.

Electromagnetic navigation bronchoscopy: A descriptive analysis

Steven Leong  1 , Hong Ju, Henry Marshall, Rayleen Bowman, Ian Yang, Ann-Maree Ree, Cathy Saxon, Kwun M Fong
Affiliations

Electromagnetic navigation bronchoscopy: A descriptive analysis

Steven Leong et al. J Thorac Dis. .

Abstract

Electromagnetic navigation bronchoscopy (ENB) is an exciting new bronchoscopic technique that promises accurate navigation to peripheral pulmonary target lesions, using technology similar to a car global positioning system (GPS) unit. Potential uses for ENB include biopsy of peripheral lung lesions, pleural dye marking of nodules for surgical wedge resection, placement of fiducial markers for stereotactic radiotherapy, and therapeutic insertion of brachytherapy catheters into malignant tissue. This article will describe the ENB procedure, review the published literature, compare ENB to existing biopsy techniques, and outline the challenges for widespread implementation of this new technology.

Keywords: Electromagnetic navigation bronchoscopy; brachytherapy; global positioning system; stereotactic radiotherapy; surgical wedge resection.

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Conflict of interest statement

No potential conflict of interest.

Figures

Figure 1
Figure 1
SuperDimension steering catheter handle: note the black arrows on the yellow ring of the catheter neck indicating the turning direction of the locatable guide.
Figure 2
Figure 2
A: superDimension steering catheter handle; B: locatable guide housed in blue Extended Working Channel (EWC); C: EWC locking device screws onto the bronchoscope working channel port.
Figure 5
Figure 5
iLogic virtual bronchoscopy pre-planning screen. Note four viewports showing axial, coronal and sagittal CT views and virtual bronchoscopy view. Green sphere represents the target lesion, the Purple line indicates mapped pathway and purple dots represent anatomical registration points.
Figure 7
Figure 7
The superDimension location board is placed underneath the patient's mattress on a metal free bed, ensuring that the target lesion will be encompassed by a rectangular prism 50 cm above the location board and the board is correctly orientated to the patient's head.
Figure 8
Figure 8
The Electromagnetic Navigation Bronchoscopy procedural computer stack situated in the bronchoscopy suite.
Figure 6
Figure 6
superDimension procedure screen showing 6 viewports. Clockwise from top left: axial CT view, MIP view, dynamic 3D view, tip view, local view, sagittal CT view. The green sphere is the target lesion and the yellow ring represents the catheter handle.
Figure 3
Figure 3
Catheter handle and locatable guide housed in blue Extended Working Channel - catheter in neutral position.
Figure 4
Figure 4
Squeezing of neck of catheter handle in the direction of the white arrow results in deflection of LG and EWC. The direction of deflection is controlled by turning the orange ring (black arrows) to any one of eight pre-set positions.
See this image and copyright information in PMC

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