Improving outcomes in electromagnetic navigation bronchoscopy-guided transbronchial microwave ablation for pulmonary nodules: the role of cone-beam computed tomography.

BACKGROUND

Studies have shown the potential of electromagnetic navigation bronchoscopy (ENB)-guided transbronchial microwave ablation (MWA) for treating pulmonary nodules. The role of cone-beam computed tomography (CBCT) in the procedure remains unknown.

OBJECTIVES

To investigate the efficacy and safety of employing CBCT during ENB-guided transbronchial MWA for pulmonary nodules.

DESIGN

Retrospective analysis of clinical records.

METHODS

Patients who underwent ENB-guided transbronchial MWA at the Department of Thoracic Surgery, Tongji Hospital. Patients were categorized into two groups: those who received CBCT during the procedure and those who did not. Technical and ablation success rates, complication rates, and patient characteristics were assessed.

RESULTS

A total of 283 patients with 371 nodules were included in the final analysis. The technical success rate was significantly higher in the CBCT group (97.0%) compared to the non-CBCT group (91.5%,  = 0.034). The overall ablation success rate was 88.1%, with the CBCT group demonstrating a higher rate (90.9% vs 81.5%,  = 0.018). Complication rates were similar between the two groups, with no significant differences.

CONCLUSION

The use of CBCT in ENB-guided transbronchial MWA significantly increases the technical and ablation success rates without raising complication rates. These findings underscore the potential advantages of CBCT in enhancing procedural outcomes for patients with pulmonary nodules. Further validation through larger, multi-center studies with longer follow-up is warranted.