Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Amalienstr. 5, D-69126 Heidelberg, Germany.
Expert Rev Respir Med. 2009 Oct;3(5):469-73. doi: 10.1586/ers.09.36.
Unfortunately, flexible bronchoscopy, the least invasive bronchoscopic procedure, is of limited value for obtaining tissue from lesions in the peripheral segments of the lung. Biopsy success is further compromised if the lesion is less than 3 cm in diameter. The main limitation of flexible bronchoscopy is the difficulty in reaching peripheral lesions with the accessory tools. In this paper, we will discuss a new bronchoscopic advance in the diagnosis and treatment of lung cancer. Once extended beyond the tip of the bronchoscope, these tools are difficult to guide to the desired location. Localizing the lesion under fluoroscopy is difficult, and alternative diagnostic guidance methods, such as computer tomography-guided bronchoscopy and endobronchial ultrasound, are more demanding. Therefore, new methods for navigation and localization are needed. One of these new technologies is electromagnetic navigation bronchoscopy. The aim of this special report is to provide an analysis of the published literature. A literature search was constructed and performed on PubMed to identify the literature from 2000 to 2008. The search words were 'electromagnetic navigation', 'coin lesion', 'solitary pulmonary nodule' and 'lung cancer'. We review a number of recent studies that utilize electromagnetic navigation and guidance, and analyze their performance characteristics for clinical applications of the technology. Electromagnetic navigation is likely to play an increasing and integral role in the diagnosis and staging of lung cancer in the near future. Electromagnetic registration may impact both the staging and diagnosis of peripheral lesions.
不幸的是，作为最微创的支气管镜检查，柔性支气管镜对于获取肺部外周段病变的组织的作用有限。如果病变的直径小于 3 厘米，活检的成功率会进一步降低。柔性支气管镜的主要局限性在于难以使用辅助工具到达外周病变。在本文中，我们将讨论一种新的支气管镜诊断和治疗肺癌的进展。这些工具一旦超出支气管镜的尖端，就很难引导到所需的位置。在荧光透视下定位病变很困难，并且需要替代的诊断引导方法，如计算机断层扫描引导支气管镜检查和支气管内超声，这些方法要求更高。因此，需要新的导航和定位方法。其中一项新技术是电磁导航支气管镜。本特别报告的目的是对已发表的文献进行分析。在 PubMed 上构建并进行了文献检索，以确定 2000 年至 2008 年的文献。检索词为“电磁导航”、“硬币样病变”、“孤立性肺结节”和“肺癌”。我们回顾了一些利用电磁导航和引导的最近的研究，并分析了它们的性能特征，以了解该技术在临床应用中的表现。在不久的将来，电磁导航可能会在肺癌的诊断和分期中发挥越来越重要的作用。电磁注册可能会影响外周病变的分期和诊断。
