P140. Assessing the Accuracy of a Novel Multi-Section Robotic Bronchoscope in Localization & Targeting of Small Pulmonary Lesions
Presented During: Thoracic Poster Session IV*
Massachusetts General Hospital
Brookline, MA
United States - Contact Me
Fumitaro Masaki
Fumitaro Masaki is a Visting Scientist at Massacheusetts General Hospital, Division of Thoracic Surgery, and a senior scientist at Canon Medical Research USA.
Monday, May 8, 2023: 3:15 PM - 3:18 PM
3 Minutes
Los Angeles Convention Center
Room: Exhibit Hall
Description
Objective: In light of the newly adopted lung cancer screening guidelines, the ability to definitively diagnosis early-stage lung cancer within small pulmonary nodules is critical. Despite viable methods such as electromagnetic navigational bronchoscopy (EM-NB), there is still an unmet need for rapid, accurate, and minimally invasive biopsy techniques for patients with small peripheral lung lesions. Robotic bronchoscopy (RB) has emerged as a novel technique to address this issue. The objective of this study was to quantitatively assess the accuracy of a multi-section robotic bronchoscope compared to current standards of care.
Methods: This is a prospective, single-blinded, randomized, comparative study where the accuracy of RB was compared against the accuracy of standard EM-NB during lesion localization and targeting. 5 blinded subjects of varying bronchoscopy experience were recruited to use both RB and EM-NB in a swine lung model. Accuracy of localization and targeting success was measured as the distance from the center of pulmonary targets at each anatomic location. Subjects used both RB and EM-NB to navigate to 4 pulmonary targets assigned using 1:1 block randomization. Differences in accuracy and time between navigation systems were assessed using Wilcoxon Rank Sum test.
Results: Both RB and EM-NB were driven to 4 independent targets twice for a total of 40 attempts each (8 per subject per bronchoscopic modality). Of the 40 total targeting attempts per modality, 90% and 85% attempts were successful when utilizing RB and EM-NB, respectively. No significant differences were found between the two bronchoscopy modalities with regard to total navigation time. Upon targeting completion, RB was found to have a significantly lower median distance to the real-time EM target (1.1 mm, IQR:0.6-2.0mm) compared to EM-NB (2.6mm, IQR:1.6-3.8). Median target displacement resulting from lung deformation was found to be significantly lower when using RB (0.8mm, IQR:0.5-1.2mm) compared to EM-NB (2.6mm, IQR:1.4-6.4mm).
Conclusions: The results of our study highlight the clear advantage of RB compared to standard EM-NB in terms of targeting accuracy. This is likely attributable to the three-section RB which mitigates the large tissue displacement observed with standard EM-NB navigation. As RB development and implementation continues to improve, so will our ability to definitively diagnosis smaller lung cancer nodules-continuing the improvement of patient outcomes.
Methods: This is a prospective, single-blinded, randomized, comparative study where the accuracy of RB was compared against the accuracy of standard EM-NB during lesion localization and targeting. 5 blinded subjects of varying bronchoscopy experience were recruited to use both RB and EM-NB in a swine lung model. Accuracy of localization and targeting success was measured as the distance from the center of pulmonary targets at each anatomic location. Subjects used both RB and EM-NB to navigate to 4 pulmonary targets assigned using 1:1 block randomization. Differences in accuracy and time between navigation systems were assessed using Wilcoxon Rank Sum test.
Results: Both RB and EM-NB were driven to 4 independent targets twice for a total of 40 attempts each (8 per subject per bronchoscopic modality). Of the 40 total targeting attempts per modality, 90% and 85% attempts were successful when utilizing RB and EM-NB, respectively. No significant differences were found between the two bronchoscopy modalities with regard to total navigation time. Upon targeting completion, RB was found to have a significantly lower median distance to the real-time EM target (1.1 mm, IQR:0.6-2.0mm) compared to EM-NB (2.6mm, IQR:1.6-3.8). Median target displacement resulting from lung deformation was found to be significantly lower when using RB (0.8mm, IQR:0.5-1.2mm) compared to EM-NB (2.6mm, IQR:1.4-6.4mm).
Conclusions: The results of our study highlight the clear advantage of RB compared to standard EM-NB in terms of targeting accuracy. This is likely attributable to the three-section RB which mitigates the large tissue displacement observed with standard EM-NB navigation. As RB development and implementation continues to improve, so will our ability to definitively diagnosis smaller lung cancer nodules-continuing the improvement of patient outcomes.
Presentation Duration
2 minute presentation; 1 minute discussion.