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==Pre-navigation bronchoscopic biopsy== {| class="wikitable mw-collapsible" |- ||''Text to copy and insert, optimised for Sectra standard report texts. Click to expand. '' |- | '''Auto-inserted clinical details:'''<br /> <RequestCaseHistory><br /> <RequestReason><br /> '''Report:'''<br /> Scan quality: [Excellent/Good/Poor]<br /> Nodule or mass location: [Right/Left] lung [] lobe [] Segment<br /> Size: [] mm<br /> Bronchus sign: [Positive (type A), type B, negative (type C)]<br /> Lymphadenopathy: []<br /> Lung parenchyma: []<br /> Remaining soft tissues: []<br /> Bones: []<br /> |} {| class="wikitable" |- !Heading !Options !Reason |- ||Scan quality: ||Excellent/Good/Poor || |- ||Nodule or mass location: ||Lung, lobe, segment || |- ||Size: ||Insert options here ||Usually nodules that can be targeted using this technique are between 1 and 2 cm or 2 cm and above (the latter is the size seen in the literature supporting electromagnetic navigational bronchoscopy). |- ||Bronchus sign: ||Insert options here ||Bronchus sign type A is a bronchus leading straight to the lesion (positive), type C is no bronchus (negative) and type B is in between. If a lesion is below 10 mm it is difficult to target without a positive bronchus sign. |- ||Lymphadenopathy: || ||Lymph node targeted EBUS may be combined with this procedure to give staging |- ||Lung parenchyma: || || These patients may have more severe lung disease than those considered for percutaneous biopsy. |- ||Remaining soft tissues: || || |- ||Bones: || || |} ''References:''<br /> 1. Bronchus sign on thin-section computed tomography is a powerful predictive factor for successful transbronchial biopsy using endobronchial ultrasound with a guide sheath for small peripheral lung lesions: a retrospective observational study Tomoyuki Minezawa, Takuya Okamura, Hiroshi Yatsuya, Naoki Yamamoto, Sayako Morikawa, Teppei Yamaguchi, Mariko Morishita, Yoshikazu Niwa, Tomoko Takeyama, Yuki Mieno, Tami Hoshino, Sakurako Uozu, Yasuhiro Goto, Masamichi Hayashi, Sumito Isogai, Masaki Matsuo, Toru Nakanishi, Naozumi Hashimoto, Mitsushi Okazawa and Kazuyoshi Imaizumi BMC Medical Imaging201515:21 https://doi.org/10.1186/s12880-015-0060-5<br /> 2. Gildea TR, Mazzone PJ, Karnak D, Meziane M, Mehta AC. Electromagnetic navigation diagnostic bronchoscopy: a prospective study. Am J Respir Crit Care Med. 2006;174(9):982-9. <br /> 3. The Annals of Thoracic Surgery Volume 93, Issue 3, March 2012, Pages 944-950 Electromagnetic Navigation Bronchoscopy Performed by Thoracic Surgeons: One Center's Early Success Presented at the Forty-seventh Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 31–Feb 2, 2011.<br /> 4. Khan KA, Nardelli P, Jaeger A, O'Shea C, Cantillon-Murphy P, Kennedy MP. Navigational Bronchoscopy for Early Lung Cancer: A Road to Therapy. Adv Ther. 2016;33(4):580-96. <br /> 5. Electromagnetic navigation bronchoscopy to access lung lesions in 1,000 subjects: first results of the prospective, multicenter NAVIGATE study Sandeep J. Khandhar†, Mark R. Bowling, Javier Flandes, Thomas R. Gildea, Kristin L. Hood, William S. Krimsky, Douglas J. Minnich, Septimiu D. Murgu, Michael Pritchett, Eric M. Toloza, Momen M. Wahidi, Jennifer J. Wolvers, Erik E. Folch BMC Pulmonary MedicineBMC series 201717:59 https://doi.org/10.1186/s12890-017-0403-9
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