SIR 2024
General IR
Sanjit Datta, MD (he/him/his)
Resident
Weill Cornell Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Peyton Cramer, MD (she/her/hers)
Resident
Weill Cornell Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Kimberly Scherer, DO
Assistant Professor of Radiology
Weill Cornell/New York Presbyterian
Financial relationships: Full list of relationships is listed on the CME information page.
Eugene Shostak, MD
Attending Interventional Pulmonologist
Weill Cornell Medicine
Disclosure information not submitted.
Bradley B. Pua
Associate Professor of Radiology, Division Chief
New York Presbyterian - Weill Cornell Medical College
Disclosure information not submitted.
A retrospective review was performed of transbronchial lung biopsies utilizing fluoroscopic image guidance at a single institution. The target lesion was identified on pre-procedure CT and coregistration was performed using either CBCT or osseous landmarks on multiple fluoroscopic views, enabling the target lesion to be overlaid on live fluoroscopy (AW Volume Viewer, GE Healthcare, Chicago, IL). EMNB was used to navigate a bronchoscope to the nearest bronchus to the lesion (Medtronic, Minneapolis, MN). Live fluoroscopy with lesion overlay was used to guide needle passes from the bronchoscope into the lesion. Technical success and outcomes were reviewed.
Results:
Six lung lesions with a mean diameter of 1.5 cm were biopsied, with an average of 6.8 FNA samples per lesion. Mean patient age was 61 years old. Mean procedure length was 60.2 minutes. Sample adequacy was assessed by an on-site cytologic technologist in 3 cases, all yielding adequate samples. Biopsies were diagnostic in 4 cases. In the 2 nondiagnostic biopsies, subsequent percutaneous biopsies were diagnostic. There were no immediate complications.
Conclusion:
The technique described was a safe and efficient method for bronchoscopic biopsy in our initial experience. The use of advanced segmentation and overlay tools enable live fluoroscopic visualization of respiratory motion and guidance for transbronchial needle passes, eliminating the time and radiation associated with post-pass CBCT to confirm intralesional position. Intraprocedural assessment of sample adequacy reduces the rate of non-diagnostic biopsy.