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Review
. 2020 Jun;12(6):3272-3278.
doi: 10.21037/jtd.2020.03.85.

Cone beam navigation bronchoscopy: the next frontier

George Z Cheng  1 , Lihua Liu  2   3 , Matthew Nobari  1 , Russell Miller  1   4 , Momen Wahidi  2
Affiliations
Review

Cone beam navigation bronchoscopy: the next frontier

George Z Cheng et al. J Thorac Dis. 2020 Jun.

Abstract

Navigation bronchoscopy has reached a new horizon in its evolution. Combining with real-time imaging modalities, such as cone-beam computed tomography (CBCT) and augmented fluoroscopy (AF), navigation success can finally be confirmed with high degree of accuracy in real-time. With utilization of this modality, additional clinical observations are being made to help address the CT-body divergence problem and further improve navigation accuracy. This review focuses on description of CBCT navigation technique, provide tips on addressing CT-Body divergence, and review evidence for CBCT applications in navigation bronchoscopy.

Keywords: Cone-beam computed tomography (CBCT); augmented fluoroscopy (AF); navigation bronchoscopy.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd.2020.03.85). The series “Novel Diagnostic Techniques for Lung Cancer” was commissioned by the editorial office without any funding or sponsorship. GZC has served as a consultant to Boston Scientific; Medtronic plc; Pinnacle Biologics, Inc.; and Restor3D and has received research funding from Intuitive Surgical Inc. and Pinnacle Biologics, Inc. MW served as a consultant to Boston Scientific; Nuvaira Inc.; Olympus Corporation; and Veracyte, Inc. and has served as a reviewer on the Data Safety Monitoring Board for CSA Medical Inc. The other authors have no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
CBCT ENB procedure in a patient with cystic lesion. (A) Patient with cystic lesion in the lateral subsegment of the right lower lobe; (B) AF showing the location of the nodule; (C) AP view of the nodule and biopsy forceps; (D) lateral view of the nodule and biopsy forceps. AF, augmented fluoroscopy; AP, anteroposterior; CBCT, cone beam computed tomography; ENB, electromagnetic navigation bronchoscopy.
Figure 2
Figure 2
Patient with a partially solid lesion in the posterior subsegment of the right upper lobe. (A) AF showing the location of the nodule; (B) catheter position in relation to the nodule seen with AF; (C) flexible transbronchial biopsy needle position in catheter; (D) defection seen with transbronchial biopsy forceps after placement in the catheter; (E) computed tomography of chest showing the size and location of the partially solid nodule. AF, augmented fluoroscopy.
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019;69:7-34. 10.3322/caac.21551 - DOI - PubMed
    1. Lung Cancer Fact Sheet. American Lung Association. 2019. Available online: https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-c.... Accessed 12/23 2019.
    1. Aberle DR, Adams AM, Berg CD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011;365:395-409. 10.1056/NEJMoa1102873 - DOI - PMC - PubMed
    1. Rivera MP, Mehta AC, American College of Chest P. Initial diagnosis of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007;132:131S-48S. - PubMed
    1. Rivera MP, Mehta AC, Wahidi MM. Establishing the diagnosis of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013;143:e142S-65S. - PubMed