The diagnostic utility of virtual bronchoscopic navigation combined with endobronchial ultrasound guided transbronchial lung biopsy for peripheral pulmonary lesions

To evaluate the diagnostic utility of endobronchial ultrasound combined with virtual bronchoscopic navigation guided transbronchial lung biopsy for solitary pulmonary nodules.A total of 105 patients with suspected peripheral pulmonary lesions who underwent transbronchial lung biopsy in the First Affiliated Hospital of Guangzhou Medical University between January and December 2013 were prospectively evaluated. The patients were divided into a conventional group, an endobronchial ultrasound group(EBUS group)and a virtual bronchoscopic navigation combined with endobronchial ultrasound(VB+ EBUS) group. The diagnostic yield and operation time were compared.The lesion size of the conventional group, the EBUS group and the EBUS+ VB group were (23±8), (20±8)and(18±7)mm, respectively, and there was no significant difference in diagnostic yields by the lesion size (F=0.52, P=0.60). The EBUS+ VB group had the highest diagnostic yield(22 of 29, 76%), which was higher than that of the conventional group(17 of 36, 47%, χ(2)=7.47, P=0.024), but not that of the EBUS group(29 of 40, 72%, χ(2)=0.10, P=0.75). The EBUS group and the EBUS+ VB group did not differ in lesion location by pulmonary segments or histologic findings. The procedure time was significantly longer in the EBUS group than the EBUS+ VB group [(365±221)s verses (256±205)s, t=2.08, P=0.042].EBUS guided TBLB improves the diagnostic yield in solitary pulmonary lesions, but it should be combined with virtual bronchoscopic navigation for the optimal yield.