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Diagnostics
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Recent Advances in Diagnostic Bronchoscopy
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Recent Advances in Diagnostic Bronchoscopy

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 9866

Special Issue Editor

Dr. Kassem Harris

E-Mail Website
Guest Editor
Interventional Pulmonology Section, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, USA
Interests: bronchoscopy; transbronchial; endobronchial
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As Interventional Pulmonology continues to expand, more bronchoscopic innovations are coming to light. The introduction of robotic bronchoscopy is the most important breakthrough as well the more popular use of transbronchial cryobiopsy procedure. Many national and international bronchoscopic associations are gathering interactive communities to share their experiences in clinical research and in advancing new procedural techniques.  

In this special issue, we aim to highlight the new advances in diagnostic bronchoscopy. There will be a comprehensive review about robotic bronchoscopy and its diagnostic advantages and the use of imaging guidance such as cone-beam computed tomography and augmented fluoroscopy. We will also discuss transbronchial cryotherapy in this special issue focusing on techniques to optimize tissue acquisition while improving safety by minimizing the risks of bleeding and pneumothorax. Also, new endobronchial ultrasound (EBUS) techniques will be included such as the use EBUS-cryotherapy for sampling mediastinal lymphadenopathy. This issue will bring the latest advances in diagnostic bronchoscopy and assist providers in caring for their patients.

Dr. Kassem Harris
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bronchoscopy
  • transbronchial
  • endobronchial

Published Papers (6 papers)

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Research

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11 pages, 2229 KiB  
Article
The Use of Robotic-Assisted Bronchoscopy in the Diagnostic Evaluation of Peripheral Pulmonary Lesions: A Paradigm Shift
by Hiba Hammad Altaq, Miloni Parmar, Talal Syed Hussain, Daouk J. Salim and Fawad A. Chaudry
Diagnostics 2023, 13(6), 1049; https://doi.org/10.3390/diagnostics13061049 - 9 Mar 2023
Cited by 4 | Viewed by 1673
Abstract
Despite recent developments, evaluation of peripheral pulmonary lesions (PPL) remains clinically challenging, and the diagnostic yield of many image-guided and bronchoscopy methods is still poor. Furthermore, complications from such procedures, such as pneumothorax and airway hemorrhage, are a major concern. Recently launched robotic-assisted [...] Read more.
Despite recent developments, evaluation of peripheral pulmonary lesions (PPL) remains clinically challenging, and the diagnostic yield of many image-guided and bronchoscopy methods is still poor. Furthermore, complications from such procedures, such as pneumothorax and airway hemorrhage, are a major concern. Recently launched robotic-assisted bronchoscopy (RAB) platforms are still in the early exploration stage and may provide another tool for achieving PPL evaluation. We present our experience here as a retrospective cohort study describing the 12-month diagnostic yield with the shape-sensing Ion™ platform for minimally invasive peripheral lung biopsy. The study describes forty-two patients undergoing shape sensing robotic-assisted bronchoscopy (ssRAB) at our institute. The early performance trend reveals a lesion localization of 100% and an overall 12-month diagnostic yield of 88.10%. The diagnostic yield for lesions less than 20 mm was 76% and for lesions greater than 20 mm was 100%. We also report our complication profile; we noted no pneumothoraces, excessive bleeding, or post-operative complications. In comparison to traditional bronchoscopy and image-guided modalities, our experience shows that ssRAB can be utilized successfully to travel to extremely small peripheral lesions with a higher diagnostic yield and better safety profile. Full article
(This article belongs to the Special Issue Recent Advances in Diagnostic Bronchoscopy)
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10 pages, 699 KiB  
Article
Mobile Cone-Beam CT-Assisted Bronchoscopy for Peripheral Lung Lesions
by Moiz Salahuddin, Sami I. Bashour, Asad Khan, Gouthami Chintalapani, Gerhard Kleinszig and Roberto F. Casal
Diagnostics 2023, 13(5), 827; https://doi.org/10.3390/diagnostics13050827 - 21 Feb 2023
Cited by 6 | Viewed by 1759
Abstract
Peripheral bronchoscopy with the use of thin/ultrathin bronchoscopes and radial-probe endobronchial ultrasound (RP-EBUS) has been associated with a fair diagnostic yield. Mobile cone-beam CT (m-CBCT) could potentially improve the performance of these readily available technologies. We retrospectively reviewed the records of patients undergoing [...] Read more.
Peripheral bronchoscopy with the use of thin/ultrathin bronchoscopes and radial-probe endobronchial ultrasound (RP-EBUS) has been associated with a fair diagnostic yield. Mobile cone-beam CT (m-CBCT) could potentially improve the performance of these readily available technologies. We retrospectively reviewed the records of patients undergoing bronchoscopy for peripheral lung lesions with thin/ultrathin scope, RP-EBUS, and m-CBCT guidance. We studied the performance (diagnostic yield and sensitivity for malignancy) and safety (complications, radiation exposure) of this combined approach. A total of 51 patients were studied. The mean target size was 2.6 cm (SD, 1.3 cm) and the mean distance to the pleura was 1.5 cm (SD, 1.4 cm). The diagnostic yield was 78.4% (95 CI, 67.1–89.7%), and the sensitivity for malignancy was 77.4% (95 CI, 62.7–92.1%). The only complication was one pneumothorax. The median fluoroscopy time was 11.2 min (range, 2.9–42.1) and the median number of CT spins was 1 (range, 1–5). The mean Dose Area Product from the total exposure was 41.92 Gy·cm2 (SD, 11.35 Gy·cm2). Mobile CBCT guidance may increase the performance of thin/ultrathin bronchoscopy for peripheral lung lesions in a safe manner. Further prospective studies are needed to corroborate these findings. Full article
(This article belongs to the Special Issue Recent Advances in Diagnostic Bronchoscopy)
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Review

Jump to: Research

10 pages, 779 KiB  
Review
A Review of Endobronchial-Ultrasound-Guided Transbronchial Intranodal Forceps Biopsy and Cryobiopsy
by Michel Chalhoub, Bino Joseph and Sudeep Acharya
Diagnostics 2024, 14(9), 965; https://doi.org/10.3390/diagnostics14090965 - 6 May 2024
Viewed by 727
Abstract
Benign and malignant mediastinal lesions are not infrequently encountered in clinical practice. Mediastinoscopy has long been considered the gold standard in evaluating mediastinal pathology. Since its introduction into clinical practice, endobronchial-ultrasonography-guided transbronchial fine needle aspiration (EBUS-TBNA) has replaced mediastinoscopy as the initial procedure [...] Read more.
Benign and malignant mediastinal lesions are not infrequently encountered in clinical practice. Mediastinoscopy has long been considered the gold standard in evaluating mediastinal pathology. Since its introduction into clinical practice, endobronchial-ultrasonography-guided transbronchial fine needle aspiration (EBUS-TBNA) has replaced mediastinoscopy as the initial procedure of choice to evaluate mediastinal lesions and to stage lung cancer. Its diagnostic yield in benign mediastinal lesions and less common malignancies, however, has remained limited. This has led different proceduralists to investigate additional procedures to improve the diagnostic yield of EBUS-TBNA. In recent years, different published reports concluded that the addition of EBUS-guided intranodal forceps biopsy (IFB) and transbronchial cryobiopsy (TBCB) to EBUS-TBNA increases the diagnostic yield especially in benign mediastinal lesions and uncommon mediastinal malignancies. The purpose of this review is to describe how EBUS-IFB and EBUS-TBCB are performed, to compare their diagnostic yields, and to discuss their limitations and their potential complications. In addition, the review will conclude with a proposed algorithm on how to incorporate EBUS-IFB and EBUS-TBCB into clinical practice. Full article
(This article belongs to the Special Issue Recent Advances in Diagnostic Bronchoscopy)
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14 pages, 532 KiB  
Review
Utility and Safety of Bronchoscopic Cryotechniques—A Comprehensive Review
by Shaikh M. Noor Husnain, Abhishek Sarkar and Taha Huseini
Diagnostics 2023, 13(18), 2886; https://doi.org/10.3390/diagnostics13182886 - 8 Sep 2023
Viewed by 1089
Abstract
Cryosurgical techniques are employed for diagnostic and therapeutic bronchoscopy and serve as important tools for the management of pulmonary diseases. The diagnosis of interstitial lung disease requires multidisciplinary team discussions after a thorough assessment of history, physical exam, computed tomography, and lung-function testing. [...] Read more.
Cryosurgical techniques are employed for diagnostic and therapeutic bronchoscopy and serve as important tools for the management of pulmonary diseases. The diagnosis of interstitial lung disease requires multidisciplinary team discussions after a thorough assessment of history, physical exam, computed tomography, and lung-function testing. However, histological diagnosis is required in selected patients. Surgical lung biopsy has been the gold standard but this can be associated with increased morbidity and mortality. Transbronchial lung cryobiopsy is an emerging technique and multiple studies have shown that it has a high diagnostic yield with a good safety profile. There is wide procedural variability and the optimal technique for cryobiopsy is still under investigation. There is emerging data that demonstrate that cryobiopsy is safe and highly accurate in the diagnosis of thoracic malignancies. Furthermore, cryorecanalization procedures are a useful adjunct for the palliation of tumors in patients with central airway obstruction. One should keep in mind that these procedures are not free from complications and should be carried out in a specialized center by a trained and experienced bronchoscopy team. We present a review of the literature on the diagnostic and therapeutic utility of bronchoscopy-guided cryosurgical procedures and their safety profile. Full article
(This article belongs to the Special Issue Recent Advances in Diagnostic Bronchoscopy)
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13 pages, 2764 KiB  
Review
Digital Tomosynthesis: Review of Current Literature and Its Impact on Diagnostic Bronchoscopy
by Anant Jain, Adrish Sarkar, Shaikh Muhammad Noor Husnain, Brian Cody Adkinson, Ali Sadoughi and Abhishek Sarkar
Diagnostics 2023, 13(15), 2580; https://doi.org/10.3390/diagnostics13152580 - 3 Aug 2023
Viewed by 1331
Abstract
Bronchoscopy has garnered increased popularity in the biopsy of peripheral lung lesions. The development of navigational guided bronchoscopy systems along with radial endobronchial ultrasound (REBUS) allows clinicians to access and sample peripheral lesions. The development of robotic bronchoscopy improved localization of targets and [...] Read more.
Bronchoscopy has garnered increased popularity in the biopsy of peripheral lung lesions. The development of navigational guided bronchoscopy systems along with radial endobronchial ultrasound (REBUS) allows clinicians to access and sample peripheral lesions. The development of robotic bronchoscopy improved localization of targets and diagnostic accuracy. Despite such technological advancements, published diagnostic yield remains lower compared to computer tomography (CT)-guided biopsy. The discordance between the real-time location of peripheral lesions and anticipated location from preplanned navigation software is often cited as the main variable impacting accurate biopsies. The utilization of cone beam CT (CBCT) with navigation-based bronchoscopy has been shown to assist with localizing targets in real-time and improving biopsy success. The resources, costs, and radiation associated with CBCT remains a hindrance in its wider adoption. Recently, digital tomosynthesis (DT) platforms have been developed as an alternative for real-time imaging guidance in peripheral lung lesions. In North America, there are several commercial platforms with distinct features and adaptation of DT. Early studies show the potential improvement in peripheral lesion sampling with DT. Despite the results of early observational studies, the true impact of DT-based imaging devices for peripheral lesion sampling cannot be determined without further prospective randomized trials and meta-analyses. Full article
(This article belongs to the Special Issue Recent Advances in Diagnostic Bronchoscopy)
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16 pages, 1152 KiB  
Review
NSCLC in the Era of Targeted and Immunotherapy: What Every Pulmonologist Must Know
by Carley L. Mitchell, Annie L. Zhang, Debora S. Bruno and Francisco A. Almeida
Diagnostics 2023, 13(6), 1117; https://doi.org/10.3390/diagnostics13061117 - 15 Mar 2023
Cited by 2 | Viewed by 2751
Abstract
The treatment of non-small cell lung cancer has dramatically changed over the last decade through the use of targeted therapies and immunotherapies. Implementation of these treatment regimens relies on detailed knowledge regarding each tumor’s specific genomic profile, underscoring the necessity of obtaining superior [...] Read more.
The treatment of non-small cell lung cancer has dramatically changed over the last decade through the use of targeted therapies and immunotherapies. Implementation of these treatment regimens relies on detailed knowledge regarding each tumor’s specific genomic profile, underscoring the necessity of obtaining superior diagnostic tissue specimens. While these treatment approaches are commonly utilized in the metastatic setting, approval among earlier-stage disease will continue to rise, highlighting the importance of early and comprehensive biomarker testing at the time of diagnosis for all patients. Pulmonologists play an integral role in the diagnosis and staging of non-small cell lung cancer via sophisticated tissue sampling techniques. This multifaceted review will highlight current indications for the use of targeted therapies and immunotherapies in non-small cell lung cancer and will outline the quality of various diagnostic approaches and subsequent success of tissue biomarker testing. Pulmonologist-specific methods, including endobronchial ultrasound and guided bronchoscopy, will be examined as well as other modalities such as CT-guided transthoracic biopsy and more. Full article
(This article belongs to the Special Issue Recent Advances in Diagnostic Bronchoscopy)
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