• Motohiro Tamiya, Norio Okamoto, Shinji Sasada, Takayuki Shiroyama, Naoko Morishita, Hidekazu Suzuki, Emi Yoshida, Tomonori Hirashima, Kunimitu Kawahara, and Ichiro Kawase.
• Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Osaka, Japan. moto19781205@yahoo.co.jp
• Respirology. 2013 Jul 1; 18 (5): 834-9.

Background And ObjectiveThe yield of biopsy performed during bronchoscopy is reduced if the lesion is smaller than 30 mm. We evaluated the performance of a new diagnostic technique combining endobronchial ultrasonography with a guide sheath (EBUS-GS) and a virtual bronchoscopic navigation system, LungPoint (Broncus Technologies, Inc., Mountain View, CA, USA), for the diagnosis of small (≤30 mm) peripheral pulmonary lesions (PPL).MethodsBetween May 2011 and December 2011, we recruited 68 consecutive patients presenting with a PPL 30 mm or less in diameter determined by chest computed tomography. We used the LungPoint system before bronchoscopy to identify the bronchus into which the bronchoscope should be advanced. We used a thin bronchoscope. EBUS-GS was performed using an endoscope ultrasonography system equipped with a 20-MHz mechanical radial-type probe. We used a guide sheath with an external diameter of 1.95 mm, thin forceps and brushing.ResultsThe diagnostic yield of the 68 PPL was 77.9%; it was 83.7% and 68.0% for the malignant and benign lesions, respectively. Notably, three cases were diagnosed by transbronchial needle-aspiration cytology alone. Univariate and multivariate analyses showed that the EBUS probe localization was the most significant contributor to successful diagnosis (diagnostic yield: within vs adjacent to the lesion = 92.1% vs 60.0%, respectively; P = 0.004 and P = 0.003, respectively).ConclusionsThe combination of EBUS-GS and LungPoint was useful for diagnosing small PPL.© 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

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