Virtual navigation for transbronchial biopsy

Transbronchial lung biopsy (TBLB) is the method of choice for diagnosis in patients with disseminated pulmonary lesion (DPL) but it bring morphologically informative material in 53.5% only. Objective: To assess the effectiveness of the virtual navigator during TBLB. Methods: clinical, radiographic, CT, TBLB , histological and a 3D simulation. In cases with disseminated pulmonary disease it is necessary to build a 3D model based on DICOM image package taken from real patient to obtain the output virtual picture of respiratory congestion and numerous small lesions, among those to choose the most suitable for biopsy . The results of lung biopsy were cut into pieces no more than 0.3 cm for hystilogy. For identification: hematoxylin and eosin stain combined with picrofuchsin Van Gieson with resorcinol - fuchsin by Weigert, and Ziehl – Nielsen methods were used. Material Study involved 19 patients. Group 1: 5 patients in whom TBLB conducted with 3D navigation. The group 2 (control): 14 patients in whom TBLB conducted without 3D navigation. Results: in group1 TBLB gave material in 5 cases (100,0%), the proportion of the received informative n=4 (80,0 %). In the control group - received 14 (100%) biopsies of them informative - 4 (28,6 %). RR1 = 0.8; RR2 = 0.29. OR = 2.8 (p >0,05). Conclusions: Proportion of informative results in a group was 2.8 higher ( p >0,05). The use of virtual navigator with simulation at the planning stage of TBLB significantly increases the proportion of informative research compared with the current technology. The relatively low cost and easy method development will give to bronchologist additional information to establish the diagnosis of DPL , which generally can reduce the probability of diagnostic errors.