Electromagnetic navigational bronchoscopy in patients with solitary pulmonary nodules
Background: Electromagnetic navigational bronchoscopy (ENB) is a tool used to help the bronchoscopist reach target lesions in the lung which would otherwise be very difficult or impossible to reach. There is ongoing debate about the usefulness of ENB.
Methods: A retrospective review of all patients with a solitary pulmonary nodule who underwent ENB between August 2010 and November 2013 was done. An analysis of the four common tools used to sample the lung through ENB at Texas Tech University Health Sciences Center in Lubbock, including transbronchial biopsy (TBBx), transbronchial needle aspiration (TBNA), transbronchial brush, and bronchoalveolar lavage (BAL), was performed. Results were analyzed to calculate the diagnostic yields of these tools.
Results: A total of 64 patients were analyzed. For all conditions, the diagnostic yields were 71%, 50%, 28%, and 23% for TBBx, TBNA, brush, and BAL, respectively. For patients with a malignant diagnosis the diagnostic yields were 75% for TBBx, 73% for TBNA, 41% for brush, and 30% for BAL.
Conclusion: The transbronchial biopsy and transbronchial needle aspiration were the most useful tools. The transbronchial brush and BAL had very low diagnostic yields and did not add to the diagnostic yield of lung cancer over that of TBBx or TBNA.
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