Filippo Patrucco1,2, Francesco Gavelli3, Matteo Daverio4, Cleto Antonini5, Renzo Boldorini6, Caterina Casadio7, Piero E Balbo4. 1. Department of Translational Medicine, Pneumology Unit U, University of Piemonte Orientale, Sant'Andrea Hospital, Vercelli, Italy. filippo.patrucco@gmail.com. 2. Division of Respiratory Medicine, Medical Department, University of Piemonte Orientale, AOU Maggiore della Carità di Novara, C.so Mazzini 18, 28100, Novara, Italy. filippo.patrucco@gmail.com. 3. Department of Translational Medicine, Emergency Medicine Unit, University of Piemonte Orientale, AOU Maggiore della Carità di Novara, Novara, Italy. 4. Division of Respiratory Medicine, Medical Department, University of Piemonte Orientale, AOU Maggiore della Carità di Novara, C.so Mazzini 18, 28100, Novara, Italy. 5. Department of Emergency Acceptance, Anaesthesia and Intensive Care, AOU Maggiore della Carità di Novara, Novara, Italy. 6. Department of Translational Medicine, Pathology Unit, University of Piemonte Orientale, AOU Maggiore della Carità di Novara, Novara, Italy. 7. Surgical Department, Thoracic Surgery Unit, University of Piemonte Orientale, AOU Maggiore della Carità di Novara, Novara, Italy.
Abstract
INTRODUCTION: Electromagnetic navigation (ENB) is a guidance tool used in the diagnosis of solitary pulmonary nodules (SPNs) and masses. Its diagnostic yield is highly variable (38-71%) and a recent study has put in doubt the role of ENB in sampling SPNs in a real-life setting. The aim of this study is to describe the 5-year experience of our center with ENB, analyzing the population, possible confounding factors, and the diagnostic yield and accuracy of this technique. METHODS: We conducted a retrospective observational study including all consecutive patients who underwent ENB for SPNs and masses from January 2011 to December 2015. RESULTS: We included 113 patients; 79% had SPNs, 21% masses. The majority were localized in the upper and middle lobes (80%) and 61% presented a bronchus sign. 54% of the patients had a previous negative fluoroscopy-guided bronchoscopy. ENB achieved the diagnosis in 78 patients (69%) with 64 malignant and 14 were benign lesions. The diagnostic yield and accuracy of ENB were respectively 0.69 and 0.76. The only factor influencing the ability to reach a diagnosis was the presence of bronchus sign (p = 0.002). No procedural complications were reported. CONCLUSION: ENB is a safe procedure with a similar diagnostic yield in the real-life and research setting. Bronchus sign is an important factor in determining the diagnostic yield. ENB efficacy can be maximized by expertise and by a careful selection of each case.
INTRODUCTION: Electromagnetic navigation (ENB) is a guidance tool used in the diagnosis of solitary pulmonary nodules (SPNs) and masses. Its diagnostic yield is highly variable (38-71%) and a recent study has put in doubt the role of ENB in sampling SPNs in a real-life setting. The aim of this study is to describe the 5-year experience of our center with ENB, analyzing the population, possible confounding factors, and the diagnostic yield and accuracy of this technique. METHODS: We conducted a retrospective observational study including all consecutive patients who underwent ENB for SPNs and masses from January 2011 to December 2015. RESULTS: We included 113 patients; 79% had SPNs, 21% masses. The majority were localized in the upper and middle lobes (80%) and 61% presented a bronchus sign. 54% of the patients had a previous negative fluoroscopy-guided bronchoscopy. ENB achieved the diagnosis in 78 patients (69%) with 64 malignant and 14 were benign lesions. The diagnostic yield and accuracy of ENB were respectively 0.69 and 0.76. The only factor influencing the ability to reach a diagnosis was the presence of bronchus sign (p = 0.002). No procedural complications were reported. CONCLUSION: ENB is a safe procedure with a similar diagnostic yield in the real-life and research setting. Bronchus sign is an important factor in determining the diagnostic yield. ENB efficacy can be maximized by expertise and by a careful selection of each case.
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