STUDY
Chen A, Pastis N, Furukawa B, et al. The effect of respiratory motion on pulmonary nodule location during electromagnetic navigation bronchoscopy. Chest. 2015;147(5):1275-1281. doi: 10.1378/chest.14-1425.
OVERVIEW
- + Retrospective study of 46 patients with 85 pulmonary lesions
- + Pulmonary lesions were identified on two CT scans performed day of procedure, and the distance between them was measured
- + Lesion size from 6.0mm–42.0mm, with a mean diameter of 16.6mm
OBJECTIVE
“…quantify pulmonary nodule movement from full inspiration to end exhalation during tidal volume breathing in patients undergoing EMN procedures.”
average movement of pulmonary lesions
AUTHORS’ CONCLUSION
“Significant movement of pulmonary lesions occurs between full inspiration and end exhalation during tidal volume breathing. This movement from full inspiration on planning chest CT scan to tidal volume breathing during bronchoscopy may significantly affect the diagnostic yield of electromagnetic navigation bronchoscopy procedures.”
KEY FINDINGS
- + Significant movement of pulmonary lesions occurs between full inspiration and end exhalation during tidal volume breathing
- + Average motion of all pulmonary lesions was 17.6mm
- Nodules in the lower lobes moved significantly more (2+cm)
- 46% of nodules moved a distance greater than their size
(measured as average diameter)
- + First-generation ENB creates a map based on full inspiration only, a state that the patient is never in during an actual bronchoscopy
- + Location of pulmonary lesions on full inspiratory planning chest CT does not reflect actual position of these lesions at time of bronchoscopy
- + Significant movement of pulmonary lesions from full inspiration on planning chest CT scan to tidal volume breathing during bronchoscopy may significantly affect diagnostic yield of EMN procedures