Interventional Pulmonology, Respiratory Institute, Cleveland Clinic , Cleveland, OH, USA.
Expert Rev Respir Med. 2020 Jul;14(7):655-669. doi: 10.1080/17476348.2020.1748012. Epub 2020 Apr 4.
Lung nodules are being identified with increasing frequency. With this growing burden of nodules comes a growing need for diagnostic technologies extending beyond the current reach of conventional bronchoscopy. One such method for diagnosing peripheral lung lesions is electromagnetic navigational bronchoscopy (ENB), which comprises a set of tools designed to aid the bronchoscopist in identifying, accessing, and sampling peripheral lung lesions under virtual guidance.
Herein we present an in-depth review of ENB, including commercially available electromagnetic navigation platforms, factors influencing diagnostic yield, adjunctive imaging and biopsy tools, potential risks, cost, technical shortcomings, and competing technologies. A review of the scientific literature was conducted primarily through PubMed, ScienceDirect, and Google Scholar, and pertinent publications and abstracts from the inception of electromagnetic navigation through early 2020 were considered. We also share our perspective on the future of ENB from both a diagnostic and a therapeutic standpoint.
ENB is currently a leading tool in the diagnostic evaluation of peripheral lung lesions. The future of ENB rests not only on its potential to expand into the therapeutic realm but also on its ability to keep pace with competing diagnostic and therapeutic technologies.
肺结节的检出率正在不断提高。随着结节负担的增加,我们需要诊断技术来扩展常规支气管镜的现有范围。电磁导航支气管镜(ENB)是一种诊断周围性肺病变的方法,它包括一套工具,旨在帮助支气管镜医生在虚拟引导下识别、进入和采集周围性肺病变。
本文深入综述了 ENB,包括市售的电磁导航平台、影响诊断率的因素、辅助成像和活检工具、潜在风险、成本、技术局限性以及竞争技术。主要通过 PubMed、ScienceDirect 和 Google Scholar 进行了科学文献的回顾,并考虑了从电磁导航开始到 2020 年初的相关出版物和摘要。我们还从诊断和治疗的角度分享了对 ENB 未来的看法。
ENB 是目前诊断周围性肺病变的主要工具。ENB 的未来不仅取决于其在治疗领域扩展的潜力,还取决于其与竞争诊断和治疗技术保持同步的能力。