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. 2016 Nov 30:10:79-85.
doi: 10.2174/1874306401610010079. eCollection 2016.

Evaluation of Pulmonary Nodules Using the Spyglass Direct Visualization System Combined With Radial Endobronchial Ultrasound: A Clinical Feasibility Study

Krystelle Godbout  1 , Simon Martel  1 , Mathieu Simon  1 , Noël Lampron  1 , Antoine Delage  1
Affiliations

Evaluation of Pulmonary Nodules Using the Spyglass Direct Visualization System Combined With Radial Endobronchial Ultrasound: A Clinical Feasibility Study

Krystelle Godbout et al. Open Respir Med J. .

Abstract

Background: Sampling of peripheral pulmonary nodules with radial endobronchial ultrasound (p-EBUS) increases diagnostic yield of bronchoscopy. However, diagnostic yield is influenced by numerous factors.

Objective: We evaluated the use of SpyGlass, a one millimeter diameter optic fiber, to obtain images of the distal mucosa and of pulmonary lesions detected with p-EBUS to determine if visual aspect of the distal mucosa was predictive of diagnosis.

Methods: We prospectively recruited subjects investigated for peripheral nodules. Bronchoscopy was performed and p-EBUS was used to locate the lesion through a guide sheath. The Spyglass fiber was introduced in the sheath to obtain images of the distal bronchial mucosa. Tissue sampling was subsequently done.

Results: Fifteen patients were enrolled in the study. A final diagnosis of malignancy was confirmed in 80%. All lesions could be located using p-EBUS (100%). Diagnostic sensitivity for p-EBUS was 58.3%. Distal mucosa could be imaged with SpyGlass in 14/15 patients (93.3%). Mucosal appearance was described as abnormal in 7 out of the 15 subjects. Mean SpyGlass procedure time was 6.5 minutes. No direct complication was reported.

Conclusion: Spyglass can be used in combination with p-EBUS to obtain images of the distal bronchial mucosa and peripheral pulmonary nodules. More patients will be needed to confirm whether mucosal appearance can be predictive of malignancy.

Keywords: Bronchoscopy; Endobronchial ultrasound; Lung cancer; Optic fiber; Peripheral nodule.

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Figures

Fig. (1)
Fig. (1)
SpyGlass optic Fiber has a diameter of 0.9 mm.
Fig. (2)
Fig. (2)
Spyglass image of normal appearing carina distinguished at the end of the guide sheath (which appears yellow in the lower part of the picture).
Fig. (3)
Fig. (3)
Spyglass image: Infiltrated aspect of the mucosa with narrowing of the bronchial lumen is seen at the end of the guide sheath. Transbronchial biopsy and cytology brushings confirmed adenocarcinoma of the lung.
See this image and copyright information in PMC

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