The following is a summary of “Accuracy of electromagnetic navigation bronchoscopy compared to fluoroscopy in navigation of transbronchial lung cryo biopsy in patients with interstitial lung disease,” published in the March 2024 issue of Pulmonology by Wang et al.

Accurate navigation is paramount for safely implementing transbronchial lung cryobiopsy (TBLC) in patients with interstitial lung disease (ILD), where the risk of post-procedure pneumothorax looms large. While traditional fluoroscopy has been the standard, its limitations in reducing complications call for exploring alternative methods. In this prospective cohort study, researchers investigated the potential of electromagnetic navigation bronchoscopy (ENB) as a more precise navigation tool.

Patients with ILD undergoing TBLC were prospectively enrolled and assigned to fluoroscopy or ENB for cryoprobe positioning. Navigation accuracy was meticulously evaluated using cone beam computed tomography (CBCT) images as the gold standard. Additionally, safety and diagnostic yield were closely observed.

Among the seventeen patients who underwent TBLC, ten were guided by fluoroscopy, while seven were guided by ENB. Fluoroscopy-guided cryoprobe navigation necessitated more adjustments for subsequent TBLC compared to ENB [9/15 (60%) vs. 1/9 (11%), p = 0.018], as confirmed by CBCT images. Notably, the two groups had no significant differences in clinical characteristics, post-procedure complications, or biopsy specimen size. Fourteen patients obtained a pathological diagnosis, and fifteen received a multidisciplinary discussion (MDD) diagnosis. However, in the fluoroscopy group, three patients failed to get a pathological diagnosis, and two were unable to obtain an MDD diagnosis.

The study underscores the significantly superior accuracy of ENB in TBLC navigation compared to traditional fluoroscopy when CBCT images are used as a reference. These findings highlight the potential value of ENB in enhancing precision and safety during TBLC procedures for ILD patients. Further research is warranted to fully elucidate the clinical benefits of ENB in this context.

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-02925-x