Form-sensing robotic bronchoscopy with cone-beam CT exhibits promise for pulmonary lesions

October 16, 2022

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Madsen Okay, et al. Authentic investigations: Novel aids within the analysis of lung most cancers: Guidelines and robots. Offered at: CHEST Annual Assembly; Oct. 16-19, 2022; Nashville, Tennessee.

Styrvoky studies no related monetary disclosures.

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NASHVILLE, Tenn. — Form-sensing robotic-assisted bronchoscopy with cone-beam CT imaging confirmed promise for diagnosing central, distal-airway and peripheral pulmonary lesions in a single-center research offered on the CHEST Annual Assembly.

Shape-sensing robotic-assisted bronchoscopy mixed with superior imaging strategies comparable to cone-beam CT is a more recent approach that enables us to diagnose and stage lung most cancers in a single process with excessive diagnostic accuracy and a very good security profile. It has potential to change into the usual of look after diagnosing pulmonary lesions if now we have additional research confirming these findings,” Kim Styrvoky, MD, assistant professor of drugs at College of Texas Southwestern Medical Middle, instructed Healio.

Kim Styrvoky, MD, quote

Knowledge have been derived from Madsen Okay, et al. Authentic investigations: Novel aids within the analysis of lung most cancers: Guidelines and robots. Offered at: CHEST Annual Assembly; Oct. 16-19, 2022; Nashville, Tennessee.

Styrvoky and colleagues reported outcomes of a retrospective evaluation of the primary 200 biopsy procedures of 209 lung lesions evaluated utilizing shape-sensing robotic-assisted bronchoscopy (Ion, Intuitive) and cone-beam CT at UT Southwestern from December 2020 to February 2022.

“Usually, sufferers who current with suspicious lung lesions bear a nonsurgical biopsy previous to definitive therapy; this may be with interventional radiology with CT-guided biopsies or bronchoscopic biopsies. The aim with bronchoscopy is that if we’re in a position to diagnose these lung nodules and carry out mediastinal staging in a single process that will doubtlessly enable sufferers to not have repeated procedures with dangers of additional problems or delaying their care,” Styrvoky instructed Healio. “The present bronchoscopic strategies for doing biopsy of lung lesions is proscribed. There have been latest advances within the area attempting to enhance that diagnostic yield.”

Form-sensing robotic-assisted bronchoscopy is a more recent expertise that contains a maneuverable catheter that enables for extra exact navigation and with direct visualization whereas navigating the airways. It allows lively robotic management of the catheter throughout navigation and the biopsy course of, based on Styrvoky. Mixed with real-time cone-beam CT imaging, this enables the doctor to verify if the catheter and lesion are in good positioning, she mentioned.

“These two applied sciences mixed are hopefully resulting in an improved diagnostic yield,” Styrvoky mentioned.

Outcomes of the primary 200 procedures to pattern 209 lesions in 198 sufferers have been as follows:

  • lesions ranged from 7 mm to 73 mm and the imply largest lesion diameter was 22.6 mm;
  • general prevalence of malignancy was 64.1%, the bulk being lung most cancers but additionally together with metastatic illness from different primaries;
  • charge of non-diagnostic sampling was 11% (23 of 209 samples);
  • diagnostic accuracy was 91.4%;
  • sensitivity was 87.3% and specificity was 98.7%; and
  • adverse predictive worth was 81.3% and constructive predictive worth was 99.2%.

Of observe, “we didn’t have a look at simply nodules; we biopsied strong lesions, floor glass lesions, infiltrates, mass-like opacities — something that actually wanted focused sampling we included on this research, which has similarities to what folks in actual apply would do, not limiting to a sure inhabitants,” Styrvoky mentioned.

The process yielded low threat for problems. Solely two sufferers had pneumothorax and there have been no main bleeding occasions, based on the outcomes.

“Along with lung most cancers, this expertise additionally has the potential for use in nonmalignant processes,” Styrvoky mentioned. “In the end, I believe this expertise can be utilized as a protected approach to get focused sampling within the lungs.”

The researchers plan to proceed to prospectively consider shape-sensing robotic-assisted bronchoscopy with cone-beam CT to guage outcomes, components that enhance diagnostic accuracy, scale back radiation publicity and finally fine-tune the process to make it as environment friendly and protected for sufferers as doable, based on Styrvoky.

This research is being offered within the Novel aids within the analysis of lung most cancers: Guidelines and robots session on Monday, Oct. 17, at 1:30 p.m.




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